The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis
Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and met...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Bak, Maarten [verfasserIn] Weltens, Irene [verfasserIn] Bervoets, Chris [verfasserIn] De Fruyt, Jürgen [verfasserIn] Samochowiec, Jerzy [verfasserIn] Fiorillo, Andrea [verfasserIn] Sampogna, Gaia [verfasserIn] Bienkowski, Przemyslaw [verfasserIn] Preuss, W. Ulrich [verfasserIn] Misiak, Blazej [verfasserIn] Frydecka, Dorota [verfasserIn] Samochowiec, Agnieszka [verfasserIn] Bak, Emma [verfasserIn] Drukker, Marjan [verfasserIn] Dom, Geert [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: European psychiatry - Cambridge : Cambridge University Press, 1991, 57, Seite 78-100 |
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| Übergeordnetes Werk: |
volume:57 ; pages:78-100 |
| DOI / URN: |
10.1016/j.eurpsy.2019.01.014 |
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| 520 | |a Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. | ||
| 650 | 4 | |a Agitation | |
| 650 | 4 | |a Agression | |
| 650 | 4 | |a Olanzapine | |
| 650 | 4 | |a Halperidol | |
| 650 | 4 | |a Rapid tranquillisation | |
| 650 | 4 | |a PANNS-EC | |
| 700 | 1 | |a Weltens, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Bervoets, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a De Fruyt, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Samochowiec, Jerzy |e verfasserin |4 aut | |
| 700 | 1 | |a Fiorillo, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Sampogna, Gaia |e verfasserin |4 aut | |
| 700 | 1 | |a Bienkowski, Przemyslaw |e verfasserin |4 aut | |
| 700 | 1 | |a Preuss, W. Ulrich |e verfasserin |4 aut | |
| 700 | 1 | |a Misiak, Blazej |e verfasserin |4 aut | |
| 700 | 1 | |a Frydecka, Dorota |e verfasserin |4 aut | |
| 700 | 1 | |a Samochowiec, Agnieszka |e verfasserin |4 aut | |
| 700 | 1 | |a Bak, Emma |e verfasserin |4 aut | |
| 700 | 1 | |a Drukker, Marjan |e verfasserin |4 aut | |
| 700 | 1 | |a Dom, Geert |e verfasserin |4 aut | |
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10.1016/j.eurpsy.2019.01.014 doi (DE-627)ELV001909606 (ELSEVIER)S0924-9338(19)30014-8 DE-627 ger DE-627 rda eng 610 DE-600 44.91 bkl Bak, Maarten verfasserin aut The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. Agitation Agression Olanzapine Halperidol Rapid tranquillisation PANNS-EC Weltens, Irene verfasserin aut Bervoets, Chris verfasserin aut De Fruyt, Jürgen verfasserin aut Samochowiec, Jerzy verfasserin aut Fiorillo, Andrea verfasserin aut Sampogna, Gaia verfasserin aut Bienkowski, Przemyslaw verfasserin aut Preuss, W. Ulrich verfasserin aut Misiak, Blazej verfasserin aut Frydecka, Dorota verfasserin aut Samochowiec, Agnieszka verfasserin aut Bak, Emma verfasserin aut Drukker, Marjan verfasserin aut Dom, Geert verfasserin aut Enthalten in European psychiatry Cambridge : Cambridge University Press, 1991 57, Seite 78-100 Online-Ressource (DE-627)320445070 (DE-600)2005377-0 (DE-576)10684606X 1778-3585 nnns volume:57 pages:78-100 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.91 Psychiatrie Psychopathologie AR 57 78-100 |
| spelling |
10.1016/j.eurpsy.2019.01.014 doi (DE-627)ELV001909606 (ELSEVIER)S0924-9338(19)30014-8 DE-627 ger DE-627 rda eng 610 DE-600 44.91 bkl Bak, Maarten verfasserin aut The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. Agitation Agression Olanzapine Halperidol Rapid tranquillisation PANNS-EC Weltens, Irene verfasserin aut Bervoets, Chris verfasserin aut De Fruyt, Jürgen verfasserin aut Samochowiec, Jerzy verfasserin aut Fiorillo, Andrea verfasserin aut Sampogna, Gaia verfasserin aut Bienkowski, Przemyslaw verfasserin aut Preuss, W. Ulrich verfasserin aut Misiak, Blazej verfasserin aut Frydecka, Dorota verfasserin aut Samochowiec, Agnieszka verfasserin aut Bak, Emma verfasserin aut Drukker, Marjan verfasserin aut Dom, Geert verfasserin aut Enthalten in European psychiatry Cambridge : Cambridge University Press, 1991 57, Seite 78-100 Online-Ressource (DE-627)320445070 (DE-600)2005377-0 (DE-576)10684606X 1778-3585 nnns volume:57 pages:78-100 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.91 Psychiatrie Psychopathologie AR 57 78-100 |
| allfields_unstemmed |
10.1016/j.eurpsy.2019.01.014 doi (DE-627)ELV001909606 (ELSEVIER)S0924-9338(19)30014-8 DE-627 ger DE-627 rda eng 610 DE-600 44.91 bkl Bak, Maarten verfasserin aut The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. Agitation Agression Olanzapine Halperidol Rapid tranquillisation PANNS-EC Weltens, Irene verfasserin aut Bervoets, Chris verfasserin aut De Fruyt, Jürgen verfasserin aut Samochowiec, Jerzy verfasserin aut Fiorillo, Andrea verfasserin aut Sampogna, Gaia verfasserin aut Bienkowski, Przemyslaw verfasserin aut Preuss, W. Ulrich verfasserin aut Misiak, Blazej verfasserin aut Frydecka, Dorota verfasserin aut Samochowiec, Agnieszka verfasserin aut Bak, Emma verfasserin aut Drukker, Marjan verfasserin aut Dom, Geert verfasserin aut Enthalten in European psychiatry Cambridge : Cambridge University Press, 1991 57, Seite 78-100 Online-Ressource (DE-627)320445070 (DE-600)2005377-0 (DE-576)10684606X 1778-3585 nnns volume:57 pages:78-100 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.91 Psychiatrie Psychopathologie AR 57 78-100 |
| allfieldsGer |
10.1016/j.eurpsy.2019.01.014 doi (DE-627)ELV001909606 (ELSEVIER)S0924-9338(19)30014-8 DE-627 ger DE-627 rda eng 610 DE-600 44.91 bkl Bak, Maarten verfasserin aut The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. Agitation Agression Olanzapine Halperidol Rapid tranquillisation PANNS-EC Weltens, Irene verfasserin aut Bervoets, Chris verfasserin aut De Fruyt, Jürgen verfasserin aut Samochowiec, Jerzy verfasserin aut Fiorillo, Andrea verfasserin aut Sampogna, Gaia verfasserin aut Bienkowski, Przemyslaw verfasserin aut Preuss, W. Ulrich verfasserin aut Misiak, Blazej verfasserin aut Frydecka, Dorota verfasserin aut Samochowiec, Agnieszka verfasserin aut Bak, Emma verfasserin aut Drukker, Marjan verfasserin aut Dom, Geert verfasserin aut Enthalten in European psychiatry Cambridge : Cambridge University Press, 1991 57, Seite 78-100 Online-Ressource (DE-627)320445070 (DE-600)2005377-0 (DE-576)10684606X 1778-3585 nnns volume:57 pages:78-100 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.91 Psychiatrie Psychopathologie AR 57 78-100 |
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10.1016/j.eurpsy.2019.01.014 doi (DE-627)ELV001909606 (ELSEVIER)S0924-9338(19)30014-8 DE-627 ger DE-627 rda eng 610 DE-600 44.91 bkl Bak, Maarten verfasserin aut The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. Agitation Agression Olanzapine Halperidol Rapid tranquillisation PANNS-EC Weltens, Irene verfasserin aut Bervoets, Chris verfasserin aut De Fruyt, Jürgen verfasserin aut Samochowiec, Jerzy verfasserin aut Fiorillo, Andrea verfasserin aut Sampogna, Gaia verfasserin aut Bienkowski, Przemyslaw verfasserin aut Preuss, W. Ulrich verfasserin aut Misiak, Blazej verfasserin aut Frydecka, Dorota verfasserin aut Samochowiec, Agnieszka verfasserin aut Bak, Emma verfasserin aut Drukker, Marjan verfasserin aut Dom, Geert verfasserin aut Enthalten in European psychiatry Cambridge : Cambridge University Press, 1991 57, Seite 78-100 Online-Ressource (DE-627)320445070 (DE-600)2005377-0 (DE-576)10684606X 1778-3585 nnns volume:57 pages:78-100 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.91 Psychiatrie Psychopathologie AR 57 78-100 |
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The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis |
| abstract |
Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. |
| abstractGer |
Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. |
| abstract_unstemmed |
Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method: A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results: Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion: Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital. |
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| title_short |
The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis |
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Weltens, Irene Bervoets, Chris De Fruyt, Jürgen Samochowiec, Jerzy Fiorillo, Andrea Sampogna, Gaia Bienkowski, Przemyslaw Preuss, W. Ulrich Misiak, Blazej Frydecka, Dorota Samochowiec, Agnieszka Bak, Emma Drukker, Marjan Dom, Geert |
| author2Str |
Weltens, Irene Bervoets, Chris De Fruyt, Jürgen Samochowiec, Jerzy Fiorillo, Andrea Sampogna, Gaia Bienkowski, Przemyslaw Preuss, W. Ulrich Misiak, Blazej Frydecka, Dorota Samochowiec, Agnieszka Bak, Emma Drukker, Marjan Dom, Geert |
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| doi_str |
10.1016/j.eurpsy.2019.01.014 |
| up_date |
2024-07-06T22:58:48.397Z |
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