Evidence for using PRN pharmacotherapy to treat undifferentiated acute agitation or aggression.
Annals of Clinical Psychiatry · 2019-01-30 · Systematic review
Abstract
BACKGROUND: This systematic review identified published studies that evaluated the use of pro re nata (PRN) medication in patients with acute agitation or aggression of undifferentiated etiology. METHODS: A literature search was conducted of PubMed and MEDLINE for randomized controlled trials (RCTs) that evaluated the use of PRN medications for individuals with undifferentiated agitation or aggression. Bibliographic databases of published articles were also searched for additional studies. RESULTS: A total of 15 studies were identified that assessed the effects of first-generation antipsychotics (FGAs), second-generation antipsychotics (SGAs), benzodiazepines, and combination therapies. All RCTs showed variable degrees of sedation and decreased agitation over time with the use of these medications, as well as variable levels of adverse events. CONCLUSIONS: Evidence exists to support the use of specific SGAs as firstline PRN medications in the management of acutely agitated individuals. While evidence exists to support the use of FGAs, benzodiazepines, and combination therapy, efficacy is similar for each class, and SGAs appear to have the most favorable adverse effect profile.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Antipsychotics · Other benzodiazepines & Z-drugs · Sedatives & anxiolytics
Related articles
- Treatment of Agitation With Lorazepam in Clinical Practice: A Systematic Review. (Front Psychiatry, 2021)
- Oral Medication for Agitation of Psychiatric Origin: A Scoping Review of Randomized Controlled Trials. (J Emerg Med, 2017)
- Pharmacological treatment of acute agitation associated with psychotic and bipolar disorder: a systematic review and meta-analysis. (Hum Psychopharmacol, 2016)
- Randomized Double-blind Trial of Intramuscular Droperidol, Ziprasidone, and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. (Acad Emerg Med, 2021)
- Ketamine for the Acute Management of Excited Delirium and Agitation in the Prehospital Setting. (Pharmacotherapy, 2018)
- Efficacy of accelerated dose titration of olanzapine with adjunctive lorazepam to treat acute agitation in schizophrenia. (Am J Emerg Med, 2004)