Mullinax Samuel, Shokraneh Farhad, Wilson Michael P, Adams Clive E
Department of Emergency Medicine Behavioral Emergences Research (DEMBER) Lab, Little Rock, Arkansas.
Neurosciences Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran; Cochrane Schizophrenia Group, Institute of Mental Health - University of Nottingham and Nottinghamshire Healthcare NHS Trust, Nottingham, United Kingdom.
J Emerg Med. 2017 Oct;53(4):524-529. doi: 10.1016/j.jemermed.2017.04.026. Epub 2017 Jul 21.
Understanding more about the efficacy and safety of oral second-generation antipsychotic medications in reducing the symptoms of acute agitation could improve the treatment of psychiatric emergencies.
The objective of this scoping review was to examine the evidence base underlying expert consensus panel recommendations for the use of oral second-generation antipsychotics to treat acute agitation in mentally ill patients.
The Cochrane Schizophrenia Group's Study-Based Register was searched for randomized controlled trials comparing oral second-generation antipsychotics, benzodiazepines, or first-generation antipsychotics with or without adjunctive benzodiazepines, irrespective of route of administration of the drug being compared. Six articles were included in the final review.
Two oral second-generation antipsychotic medications were studied across the six included trials. While the studies had relatively small sample sizes, oral second-generation antipsychotics were similarly effective to intramuscular first-generation antipsychotics in treating symptoms of acute agitation and had similar side-effect profiles.
This scoping review identified six randomized trials investigating the use of oral second-generation antipsychotic medications in the reduction of acute agitation among patients experiencing psychiatric emergencies. Further research will be necessary to make clinical recommendations due to the overall dearth of randomized trials, as well as the small sample sizes of the included studies.
深入了解口服第二代抗精神病药物在减轻急性激越症状方面的疗效和安全性，有助于改善精神科急症的治疗。
本综述的目的是探讨专家共识小组关于使用口服第二代抗精神病药物治疗精神病患者急性激越的建议所依据的证据基础。
检索Cochrane精神分裂症研究组基于研究的注册库，查找比较口服第二代抗精神病药物、苯二氮䓬类药物或第一代抗精神病药物（有无辅助使用苯二氮䓬类药物）的随机对照试验，无论所比较药物的给药途径如何。最终纳入综述的有6篇文章。
在纳入的6项试验中研究了两种口服第二代抗精神病药物。虽然这些研究的样本量相对较小，但口服第二代抗精神病药物在治疗急性激越症状方面与肌肉注射第一代抗精神病药物同样有效，且副作用相似。
本综述确定了6项随机试验，研究口服第二代抗精神病药物在减少精神病急症患者急性激越方面的应用。由于随机试验总体缺乏，且纳入研究的样本量较小，因此需要进一步研究以提出临床建议。
