Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York.
Corresponding Author: Leslie Citrome, MD, MPH, 11 Medical Park Dr, Ste 102, Pomona, NY 10970 (
Prim Care Companion CNS Disord. 2024 Jan 30;26(1):23nr03596. doi: 10.4088/PCC.23nr03596.
The prompt effective treatment of acute agitation among patients with schizophrenia or bipolar disorder can alleviate distressing symptoms for the patient and decrease the risk of escalation to aggression and the potential for serious harm to the patient, health care providers, and others. A commonly used approach for the management of acute agitation has been the intramuscular administration of antipsychotic medications and/or benzodiazepines. However, US Food and Drug Administration-approved treatments with alternative routes of delivery now include inhaled loxapine powder and, more recently, dexmedetomidine sublingual film. Two formulations of intranasal olanzapine for acute agitation are in development. Intranasal formulations offer the potential for favorable pharmacokinetics and onset of action combined with ease of delivery obviating the need for injections and are thus consistent with patient-centered factors such as preference and self-administration. In this review, alternative methods of medication delivery are discussed, with an emphasis on the potential for intranasal administration to treat acute agitation in adult patients with schizophrenia or bipolar disorder. .
对于精神分裂症或双相情感障碍患者的急性激越，及时有效的治疗可以减轻患者的痛苦症状，并降低激越升级为攻击行为的风险，以及对患者、医护人员和其他人造成严重伤害的风险。管理急性激越的常用方法一直是肌肉注射抗精神病药物和/或苯二氮䓬类药物。然而，美国食品和药物管理局（FDA）批准的替代给药途径的治疗方法现在包括吸入洛沙平粉，以及最近的右美托咪定舌下膜。两种用于急性激越的鼻内奥氮平制剂正在开发中。鼻内制剂具有良好的药代动力学和作用起效时间的潜力，并且给药方便，无需注射，因此符合患者为中心的因素，如偏好和自我给药。在这篇综述中，讨论了药物输送的替代方法，重点介绍了鼻内给药在治疗成人精神分裂症或双相情感障碍患者急性激越中的潜在应用。
