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; Maier, Nadja; Abderhalden, Christoph; Strik, Werner; Müller, Thomas Jörg (2013). Rapid tranquilization of severely agitated patients with schizophrenia spectrum disorders: a naturalistic, rater-blinded, randomized controlled study with oral haloperidol, risperidone, and olanzapine. Pharmacopsychiatry, 46(6), A77. Thieme 10.1055/s-0033-1353338

Agitation is a major problem in acute schizophrenia. Still, only limited evidence exists on antipsychotic efficacy in severely agitated patients after 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. We enrolled 43 severely agitated patients at acute care psychiatric units. Participants were randomly assigned to receive either daily haloperidol 15 mg, olanzapine 20 mg, or risperidone 2 – 6 mg over 5 days. Positive and Negative Syndrome Scale psychotic agitation (PANSS-PAS) subscore was the primary outcome variable. A mixed model analyses was applied. All drugs were effective for rapid tranquillization 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 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. Oral haloperidol, risperidone, and olanzapine seem to be suitable for treating acute severe psychotic agitation in schizophrenia spectrum disorders. We observed a gender effect with poorer outcome in women.

Item Type:

Conference or Workshop Item (Abstract)

Division/Institute:

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

UniBE Contributor:

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

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0176-3679

Publisher:

Thieme

Language:

English

Submitter:

Daniela Zurkinden

Date Deposited:

10 Apr 2014 03:05

Last Modified:

26 Apr 2017 02:28

Publisher DOI:

10.1055/s-0033-1353338

URI:

https://boris.unibe.ch/id/eprint/47933

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