TY  - JOUR
PY  - 2019//
TI  - The pharmacological management of agitated and aggressive behaviour: a systematic review and meta-analysis
JO  - European psychiatry
A1  - Bak, Maarten
A1  - Weltens, Irene
A1  - Bervoets, Chris
A1  - De Fruyt, Jürgen
A1  - Samochowiec, Jerzy
A1  - Fiorillo, Andrea
A1  - Sampogna, Gaia
A1  - Bienkowski, Przemyslaw
A1  - Preuss, W. Ulrich
A1  - Misiak, Blazej
A1  - Frydecka, Dorota
A1  - Samochowiec, Agnieszka
A1  - Bak, Emma
A1  - Drukker, Marjan
A1  - Dom, Geert
SP  - 78
EP  - 100
VL  - 57
IS  - 
N2  - 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. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2019 Elsevier Masson SAS. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0924-9338
UR  - http://dx.doi.org/10.1016/j.eurpsy.2019.01.014
ID  - ref1
ER  -