Matrone Marta, Cuomo Alessandro, De Filippis Sergio, Fagiolini Andrea, Amore Mario
Von Siebenthal Neuropsychiatric Clinic and Hospital, Genzano di Roma, Rome, Italy.
School of Medicine, Department of Molecular Medicine, University of Siena, Siena, Italy.
Drugs Context. 2024 Nov 21;13. doi: 10.7573/dic.2024-6-5. eCollection 2024.
Psychomotor agitation (PMA) is a prominent clinical issue frequently observed in various psychiatric and neurological conditions, including schizophrenia, bipolar disorder, Parkinson disease, dementia and substance use disorder. Characterized by motor restlessness, anxiety and irritability, PMA can rapidly escalate into aggression and violence, necessitating prompt intervention to ensure patient and caregiver safety. The prevalence of PMA in psychiatric emergency settings ranges from 4.3% to 10%, imposing a substantial burden on healthcare systems. Despite the critical nature of PMA, there is a lack of standardized treatment protocols, particularly concerning the use of liquid formulations of antipsychotics such as liquid promazine, which may offer unique advantages in emergency care. This review aims to provide a comprehensive analysis of the existing literature on the efficacy, safety and tolerability of liquid antipsychotics, with a particular focus on promazine, in the management of PMA. An extensive literature search was conducted across publicly available databases with no time limitations to ensure the inclusion of all relevant articles. The findings suggest that liquid promazine offers several benefits, including ease of administration, rapid onset of action and improved patient compliance, making it a valuable option in acute PMA management. However, the review also highlights the need for future research, particularly long-term studies and head-to-head comparisons with other antipsychotics, to better establish the clinical utility of liquid promazine. Future research should focus on expanding the evidence base for liquid antipsychotic formulations, which will contribute to improved clinical outcomes in the management of PMA.
精神运动性激越（PMA）是一个突出的临床问题，在各种精神和神经疾病中经常出现，包括精神分裂症、双相情感障碍、帕金森病、痴呆和物质使用障碍。PMA的特征是运动不安、焦虑和易怒，可迅速升级为攻击和暴力行为，因此需要及时干预以确保患者和护理人员的安全。PMA在精神科急诊环境中的患病率为4.3%至10%，给医疗系统带来了沉重负担。尽管PMA至关重要，但缺乏标准化的治疗方案，特别是关于使用抗精神病药物液体制剂（如液体制剂异丙嗪）的方案，而这些制剂在急诊护理中可能具有独特优势。本综述旨在全面分析现有文献中关于液体制剂抗精神病药物在PMA管理中的疗效、安全性和耐受性，尤其关注异丙嗪。我们在无时间限制的公开数据库中进行了广泛的文献检索，以确保纳入所有相关文章。研究结果表明，液体制剂异丙嗪具有多种益处，包括易于给药、起效迅速和患者依从性提高，使其成为急性PMA管理中的一个有价值的选择。然而，该综述也强调了未来研究的必要性，特别是长期研究以及与其他抗精神病药物的头对头比较，以更好地确立液体制剂异丙嗪的临床效用。未来的研究应侧重于扩大液体制剂抗精神病药物的证据基础，这将有助于改善PMA管理的临床结果。
