Psychiatria pre prax 2/2013

Forced medication

Pharmacological treatment has in the algorithm of the management of an acutely agitated patient its indisputable place and should be initiated only if previous de-escalation techniques and other non-pharmacological methods had fail. Ideal drug for such purpose should be non-invasive; easy to apply; with rapid onset of action; effectively decreasing agitation without excessive sedation; well-tolerated and should positively affect the underlying psychiatric condition. Despite the wide variety of currently available drugs nor one meets all the criteria. The review article discusses the current treatment options for agitated patients with primary psychiatric causes of agitation. Despite many existing „expert recommendations“ and the results of randomized controlled trials, a longlasting clinical experience together with economical factors plays signifiant role in the use of forced medication.

Keywords: agitation, aggression, forced medication, pharmacotherapy, coercive measures.