Intramuscular olanzapine in the management of acute agitation.
نویسندگان
چکیده
OBJECTIVE To review the current efficacy and safety evidence for the use of intramuscular olanzapine in the management of acute agitation. DATA SOURCES MEDLINE, EMBASE, and PubMed (all to March 2004) were searched for full-text, English-language publications in humans. Search terms included olanzapine, psychosis, agitation, psychiatric emergency, and intramuscular. STUDY SELECTION AND DATA EXTRACTION Prospective, randomized, controlled trials that evaluated efficacy or safety endpoints of intramuscular olanzapine in the management of acute agitation were included. All studies were evaluated independently by both authors. For clinical outcomes (efficacy, safety), the definitions as specified by each study were used. DATA SYNTHESIS Four prospective trials were included in this review. Intramuscular olanzapine is comparable to haloperidol or lorazepam monotherapy in managing acute agitation associated with schizophrenia and dementia. Intramuscular olanzapine is superior to lorazepam monotherapy in the management of agitation associated with bipolar affective disorder. Preliminary evidence demonstrates that intramuscular olanzapine is associated with fewer adverse movement disorders than monotherapy with intramuscular haloperidol. Interpretation of published evidence is limited by confounding factors of comparator regimens and the patient populations studied. CONCLUSIONS Additional studies comparing intramuscular olanzapine with combination antipsychotic/benzodiazepine therapy in more severely ill patients and patients with concomitant medical illnesses are needed to determine the most effective dosing regimen, use of adjunctive medications, and to obtain a comprehensive safety profile.
منابع مشابه
Intramuscular olanzapine in patients with borderline personality disorder: an observational study in an emergency room.
OBJECTIVE Despite the frequency of borderline personality disorder (BPD) in patients with acute agitation in emergency departments (EDs), there are few data about the use of intramuscular (IM) psychotropics in those patients. This is the first open-label study with olanzapine in this setting. METHOD Measures were collected prospectively for patients with acute agitation in ED. Consent was obt...
متن کامل10 mg intramuscular olanzapine reduces acute agitation in schizophrenia more effectively than lower doses.
متن کامل
A double-blind, placebo-controlled dose-response comparison of intramuscular olanzapine and haloperidol in the treatment of acute agitation in schizophrenia.
BACKGROUND An intramuscular (IM) formulation of olanzapine has been developed because there are no rapid-acting IM atypical antipsychotic drugs currently available in the United States for treating acute agitation in patients with schizophrenia. METHODS Recently hospitalized acutely agitated patients with schizophrenia (N = 270) were randomized to receive 1 to 3 IM injections of olanzapine (2...
متن کاملManagement of agitation in the acute psychotic patient--efficacy without excessive sedation.
Rapid-acting intramuscular (IM) formulations of atypical antipsychotics offer a significant advance over IM haloperidol in the short-term management of acute schizophrenic episodes. Several short-term open-label randomised studies, typically enrolling two- to three-hundred patients, have compared an atypical antipsychotic with haloperidol. These studies show that IM ziprasidone, IM olanzapine a...
متن کاملA randomized, double-blind, placebo-controlled study of rapid-acting intramuscular olanzapine in Japanese patients for schizophrenia with acute agitation
BACKGROUND Olanzapine rapid-acting intramuscular (IM) injection is an atypical antipsychotic drug already used overseas and recently approved in Japan. The objective of this study was to confirm the efficacy of rapid-acting IM olanzapine 10 mg was greater than IM placebo in patients with exacerbation of schizophrenia with acute psychotic agitation by comparing changes from baseline to 2 hours a...
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ورودعنوان ژورنال:
- The Annals of pharmacotherapy
دوره 38 12 شماره
صفحات -
تاریخ انتشار 2004