Kousgaard Sabrina Just, Licht Rasmus W, Nielsen René Ernst
Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Pharmacopsychiatry. 2017 Jul;50(4):129-135. doi: 10.1055/s-0043-100766. Epub 2017 Mar 14.
Benzodiazepines are commonly used for the treatment of acute agitation in a psychiatric setting.We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications. Randomized trials evaluating intramuscular (IM) midazolam or lorazepam given as monotherapy or as add-on treatment, with more than 10 patients aged 18-65 years, conducted in a psychiatric setting, and published between January 1, 1980, and February 3, 2016, were included. 16 studies from a search result of 5 516 studies were included. In total, 577 patients were treated with lorazepam IM 2-4 mg, and 329 patients were treated with midazolam IM 5-15 mg. It is unclear whether lorazepam IM or midazolam IM is as efficacious as an antipsychotic IM. It is a bit more certain that the combination of benzodiazepines IM and a low dose antipsychotic IM is more efficacious than the benzodiazepine and the antipsychotic alone. However, there is no doubt that benzodiazepines are less likely to be associated with treatment emergent side effects, as compared to antipsychotics.
苯二氮䓬类药物常用于精神科环境中急性激越的治疗。我们检索了MEDLINE、EMBASE、PsycINFO以及Cochrane对照试验中央注册库（CENTRAL）以获取相关出版物。纳入了在精神科环境中进行的、针对18 - 65岁超过10名患者、评估肌内注射（IM）咪达唑仑或劳拉西泮作为单一疗法或附加疗法、且发表于1980年1月1日至2016年2月3日之间的随机试验。从5516项研究的检索结果中纳入了16项研究。总共，577例患者接受了2 - 4毫克肌内注射劳拉西泮治疗，329例患者接受了5 - 15毫克肌内注射咪达唑仑治疗。目前尚不清楚肌内注射劳拉西泮或肌内注射咪达唑仑是否与肌内注射抗精神病药物一样有效。比较确定的是，肌内注射苯二氮䓬类药物与低剂量肌内注射抗精神病药物联合使用比单独使用苯二氮䓬类药物和抗精神病药物更有效。然而，毫无疑问，与抗精神病药物相比，苯二氮䓬类药物与治疗中出现的副作用关联较小。
