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}
}
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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.

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References

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Are Low Doses of Antipsychotics Effective in the Management of Psychomotor Agitation? A Randomized, Rated-Blind Trial of 4 Intramuscular Interventions

Low doses of haloperidol combined with midazolam can be as effective as olanzapine in reducing psychomotor agitation without increasing the risk of extrapyramidal effects.

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Whether haloperidol alone is an effective treatment for psychosis-induced aggression or agitation, wherein clinicians are required to intervene to prevent harm to self and others is examined.

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Haloperidol alone, administered orally, intramuscularly or intravenously, is effective treatment for psychosis-induced agitation or aggression and, with notable exceptions, most were small and carried considerable risk of bias.

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Intramuscular aripiprazole is effective in patients with acute agitation associated with schizophrenia, comparable to IM haloperidol, and enables convenient transfer to oral aripIPrazole therapy.

Assessment and management of agitation in psychiatry: Expert consensus

  • M. GarrigaI. Pacchiarotti E. Vieta
  • Medicine, Psychology
    The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
  • 2016
Recommendations on the assessment of agitation emphasise the importance of identifying any possible medical cause and the “ideal” medication should calm without over-sedate.

Efficacy and safety of intramuscular aripiprazole in patients with acute agitation: a randomized, double-blind, placebo-controlled trial.

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The effects of droperidol, including its cost-effectiveness, when compared to placebo, other 'standard' or 'non-standard' treatments, or other forms of management of psychotic illness, in controlling acutely disturbed behaviour and reducing psychotic symptoms in people with schizophrenia-like illnesses are estimated.

Intramuscular Aripiprazole in the Control of Agitation

Improvements with aripiprazole IM appeared to be specific to core agitation symptoms, as opposed to nonspecific sedation, and to be independent of baseline level of agitation.
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