The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis

@article{Bak2019ThePM,
  title={The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis},
  author={Maarten Bak and Irene Weltens and Chris Bervoets and J{\"u}rgen De Fruyt and Jerzy Samochowiec and Andrea Fiorillo and Gaia Sampogna and Przemysław Bieńkowski and W Ulrich Preuss and Błażej Misiak and Dorota Frydecka and Agnieszka Samochowiec and Emma Bak and Marjan Drukker and Geert Dom},
  journal={European Psychiatry},
  year={2019},
  volume={57},
  pages={78 - 100}
}
Effectiveness and safety of intravenous valproate in agitation: a systematic review.
TLDR
Intravenous valproate seems efficacious in reducing agitation in psychiatric patients; it generally appears safe compared to other neuroleptics or antiepileptics; however, the evidence is still not strong as it  relies mainly on open-label studies or case series.
Psychopharmacology of agitation in acute psychotic and manic episodes
TLDR
The best approach is to summarize in some detail the evidence for each possible treatment and the interpretations published recently on each of those treatments, and then present recommendations for medication management in tiered rankings, based on the authors’ qualitative review of the data and opinions.
Effect of Sublingual Dexmedetomidine vs Placebo on Acute Agitation Associated With Bipolar Disorder: A Randomized Clinical Trial.
TLDR
Among patients with mild to moderate agitation associated with bipolar disorder, treatment with a sublingual film formulation of dexmedetomidine 120 μg or 180 μg, compared with placebo, resulted in significantly greater reduction in the agitation score at 2 hours.
The Management of Psychomotor Agitation Associated with Schizophrenia or Bipolar Disorder: A Brief Review
TLDR
The purpose of this brief review is to raise awareness about best practices for the management of PMA in emergency care situations and consider the role of new pharmacological interventions in patients with agitation associated with bipolar disorder or schizophrenia.
The treatment of acute agitation associated with schizophrenia or bipolar disorder: investigational drugs in early stages of their clinical development, and their clinical context and potential place in therapy
TLDR
Although it is too early to make definitive statements about tolerability and efficacy, their unique administration mechanisms suggest that dexmedetomidine film and intranasal olanzapine may become valuable options for the rapid management of acute agitation in patients who are willing to cooperate with medication therapy.
Droperidol for Agitation in Acute Care
Comparative evidence supports that droperidol is as effective as haloperidol and olanzapine for the sedation of adult patients with uncontrolled aggression, anxiety, or violent behaviour in acute
Which Emergent Medication Should I Give Next? Repeated Use of Emergent Medications to Treat Acute Agitation
TLDR
Examination of evidence available in the literature and clinical algorithms suggested by the authors for sequential medication administration in patients with persistent acute agitation in psychiatric emergency settings discuss risk factors for medication-related adverse events and provide options for patients who are able to take oral medications and for Patients who require parenteral intervention.
Evaluation of long-acting injectable antipsychotics with the corresponding oral formulation in a cohort of patients with schizophrenia: a real-world study in Spain
TLDR
LAIs improved clinical outcomes by reducing the need for concomitant treatments and hospital admissions over oral antipsychotics, and showed better outcomes versus A1M and biweekly LAIs.
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TLDR
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The responses suggest that physicians can make provisional diagnoses with some confidence and that pharmacological and nonpharmacological interventions are selected differentially based on diagnosis and other salient demographic and medical features.
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