Psychiatria pre prax 2/2003

SECOND GENERATION ANTIPSYCHOTICS IN TREATMENT OF ACUTE PSYCHOTIC AGITATION

Various psychotic disorders, including schizophrenia, may be associated with symptoms of acute agitation, or even aggression. In the pharmacotherapy of acute agitation, we can use so called rapid tranquilization. Besides drug treatment, non-pharmacological interventions, environmental and behavioral, are important part of the complex approach. The most extensively used psychotropic drugs are parenteral formulas of conventional antipsychotics and benzodiazepines. More recently, injection forms of some second generation antipsychotics, olanzapine and ziprasidone, have become available. Both drugs have shown their efficacy and tolerability in several double-blind trials of intramuscular administration in acutely agitated psychotic patients. Comparing to the conventional medication, injection forms of the novel antipsychotics have a faster onset of action and overall more favorable profile of side effects. Thus, they should become a first-line choice in the treatment of acute psychotic agitation.

Keywords: agitation, schizophrenia, second generation antipsychotics, olanzapine, ziprasidone.