Rapid tranquilization of severely agitated patients with schizophrenia spectrum disorders: a naturalistic, rater-blinded, randomized, controlled study with oral haloperidol, risperidone, and olanzapine

Walther, Sebastian; Moggi, Franz; Horn, Helge Joachim; Moskvitin, Konstantin; Abderhalden, Christoph; Maier, Nadja; Strik, Werner; Müller, Thomas Jörg (2014). Rapid tranquilization of severely agitated patients with schizophrenia spectrum disorders: a naturalistic, rater-blinded, randomized, controlled study with oral haloperidol, risperidone, and olanzapine. Journal of Clinical Psychopharmacology, 34(1), pp. 124-128. Lippincott Williams & Wilkins 10.1097/JCP.0000000000000050

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INTRODUCTION Agitation is a major problem in acute schizophrenia. Only a few studies have tested antipsychotic agents in severely agitated patients, mainly because of legal issues. Furthermore, most studies were limited to the first 24 hours. We aimed to investigate the efficacy of oral haloperidol, risperidone, and olanzapine in reducing psychotic agitation in severely agitated patients with schizophrenia or schizophreniform or schizoaffective disorder over 96 hours using a prospective, randomized, rater-blinded, controlled design within a naturalistic treatment regimen. METHODS In total, 43 severely agitated patients at acute care psychiatric units were enrolled. Participants were randomly assigned to receive either daily haloperidol 15 mg, olanzapine 20 mg, or risperidone 2 to 6 mg over 5 days. Positive and Negative Syndrome Scale psychotic agitation subscale score was the primary outcome variable. A mixed-model analysis was applied. RESULTS All drugs were effective for rapid tranquilization within 2 hours. Over 5 days, the course differed between agents (P < 0.001), but none was superior. Dropouts occurred only in the risperidone and olanzapine groups. Men responded better to treatment than did women during the initial 2 hours (P = 0.046) as well as over the 5-day course (P < 0.001). No difference between drug groups was observed regarding diazepam or biperiden use. CONCLUSIONS Oral haloperidol, risperidone, and olanzapine seem to be suitable for treating acute severe psychotic agitation in schizophrenia spectrum disorders. Response to oral antipsychotics demonstrated a gender effect with poorer outcome in women throughout the study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > Department of Nursing and Education
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04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Psychiatric Neurophysiology (discontinued)
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Management
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > UPD Murtenstrasse

UniBE Contributor:

Walther, Sebastian; Moggi, Franz; Horn, Helge Joachim; Abderhalden, Christoph; Strik, Werner and Müller, Thomas Jörg

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0271-0749

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Sebastian Walther

Date Deposited:

17 Jan 2014 10:17

Last Modified:

23 Oct 2015 07:16

Publisher DOI:

10.1097/JCP.0000000000000050

PubMed ID:

24346752

BORIS DOI:

10.7892/boris.39925

URI:

https://boris.unibe.ch/id/eprint/39925

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