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A naturalistic study of pharmacological management of behavioural disturbance in psychosis

Published online by Cambridge University Press:  28 March 2012

Steve Addis ,
Diane Sherwood ,
Wendy Mace ,
Serafino G. Mancuso ,
Radhakrishnan Koloth  and
David J. Castle
Steve Addis*
Affiliation:
Consultant Psychiatrist, Clinical Director, Fremantle Mental Health Service, Fremantle Hospital and Health Service, Fremantle WA, Australia
Diane Sherwood
Affiliation:
Registered Nurse, Registered Mental Health Nurse, A/Clinical Governance Coordinator, Clinical Trials Coordinator, Fremantle Mental Health Service, Fremantle WA, Australia
Wendy Mace
Affiliation:
Registered Nurse, Registered Mental Health Nurse, Fremantle Mental Health Service B10, Fremantle WA, Australia
Serafino G. Mancuso
Affiliation:
Research Coordinator, St Vincent's Mental Health, Fitzroy VIC, Australia
Radhakrishnan Koloth
Affiliation:
Senior Medical Officer, Swan Community Mental Health Centre, Middle Swan WA, Australia
David J. Castle
Affiliation:
Chair of Psychiatry, St. Vincent's Hospital Melbourne, Fitzroy VIC, Australia
*
Correspondence to: Prof. David Castle, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy, VIC 3065; E-mail: David.Castle@svhm.org.au
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Abstract

Objective: To explore, using a naturalistic design, the efficacy of typical and atypical antipsychotics in the management of behavioural disturbance in people with psychiatric disorders.

Method: Prospective naturalistic study of 15,278 incidents of behavioural disturbance perpetrated by 1,059 patients, over a two year period.

Results: Typical and atypical antipsychotics did not differ in terms of their efficacy, overall. In terms of specific agents, haloperidol and quetiapine tended to show equal efficacy, with olanzapine being somewhat less effective on two of three outcome measures.

Conclusions: Overall, atypical antipsychotics were as effective as typical agents in the management of acute behavioural disturbance in a mental health setting. Further work is required to determine the relative side effect burden of those agents.

Keywords

Behavioural disturbanceschizophreniaanti-psychotics
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 8 , Issue 2 , August 2012 , pp. 120 - 125
Copyright
Copyright © NAPICU 2012

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References

Allen, M. H., Currier, G. W., Hughes, D. H., Docherty, J. P., Carpenter, D. and Ross, R. (2003) Treatment of behavioral emergencies: a summary of the expert consensus guidelines. Journal of Psychiatric Practice. 9(1): 16–38.CrossRefGoogle ScholarPubMed
Castle, D., Daniel, J., Knott, J., Fielding, J., Goh, J. and Singh, B. (2005) Development of clinical guidelines for the pharmacological management of behavioural disturbance and aggression in people with psychosis. Australasian Psychiatry. 13(3): 247–252.CrossRefGoogle ScholarPubMed
Castle, D., Tran, N. and Alderton, D. (2008) Management of acute arousal in psychosis. In: Castle, D., Copolov, D., Wykes, T., Mueser, K. (eds). Pharmacological and Psychosocial Treatment of Schizophrenia, 2nd edition. London: Informa. pp. 125–137.CrossRefGoogle Scholar
Currier, G. and Simpson, G. (2000) Risperidone liquid concentrate and oral lorazepam versus intramuscular haloperidol for treatment of psychotic agitation. Journal of Clinical Psychiatry. 62: 153–157.CrossRefGoogle Scholar
Daniel, J., Chamberlain, J. and Castle, D. (2007) The pharmacological management of behavioural disturbance in psychosis: a naturalistic study. Australasian Psychiatry. 15(5): 380–384.CrossRefGoogle ScholarPubMed
Kay, S. R., Fiszbein, A. and Opler, L. A. (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin. 13(2): 261–276. doi: 10.1093/schbul/13.2.261CrossRefGoogle ScholarPubMed
McAllister-Williams, R. H. and Ferrier, I. N. (2002) Rapid tranquillisation: time for a reappraisal of options for parenteral therapy. The British Journal of Psychiatry. 180(6): 485–489.CrossRefGoogle ScholarPubMed
Wright, P., Birkett, M., David, S. R., Meehan, K., Ferchland, I., Alaka, K. J., Saunders, J. C., Krueger, J., Bradley, P., San, L., Bernardo, M., Reinstein, M. and Breier, A. (2001) Double-blind, placebo-controlled comparison of intramuscular olanzapine and intramuscular haloperidol in the treatment of acute agitation in schizophrenia. American Journal of Psychiatry. 158(7): 1149–1151.CrossRefGoogle ScholarPubMed