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首页> 外文期刊>The journal of clinical psychiatry >Acute treatment of psychotic agitation: a randomized comparison of oral treatment with risperidone and lorazepam versus intramuscular treatment with haloperidol and lorazepam.
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Acute treatment of psychotic agitation: a randomized comparison of oral treatment with risperidone and lorazepam versus intramuscular treatment with haloperidol and lorazepam.

机译：精神病性激动的急性治疗：使用利培酮和劳拉西m口服治疗与氟哌啶醇和劳拉西m肌肉注射的随机比较。

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BACKGROUND: Standard treatment for acute psychotic agitation often involves intramuscular administration of the benzodiazepine lorazepam and the antipsychotic haloperidol. This study compared the efficacy and safety of oral treatment with the atypical antipsychotic risperidone plus lorazepam with those of standard intramuscular treatment. We hypothesized that the efficacy and speed of action of both treatments would be similar. METHOD: In a prospective, parallel-group, randomized, rater-blinded noninferiority study conducted at 24 sites in the United States, 162 patients exhibiting agitation associated with active psychosis were randomly assigned to receive either oral treatment with 2 mg of risperidone plus 2 mg of lorazepam (N = 83) or intramuscular treatment with 5 mg of haloperidol plus 2 mg of lorazepam (N = 79). The change scores on a 5-item acute-agitation cluster from the Positive and Negative Syndrome Scale (hallucinatory behavior, excitement, hostility, uncooperativeness, and poor impulse control) were the main outcome measure. The study was conducted from January 8 to August 8, 2001. RESULTS: Mean acute-agitation cluster scores were similar in the 2 groups at baseline. Mean score improvements at 30, 60, and 120 minutes after dosing were significant at each timepoint in both groups (p <.0001) and were similar in both groups (p >.05). Both treatments were well tolerated. CONCLUSION: A single oral dose of risperidone plus lorazepam was as effective as parenterally administered haloperidol plus lorazepam for the rapid control of agitation and psychosis. These findings suggest that this oral regimen is an acceptable alternative to the current intramuscular treatment for acute psychotic agitation.
机译：背景：急性精神病性躁动的标准治疗通常涉及肌注苯二氮卓拉拉西m和抗精神病性氟哌啶醇。这项研究比较了非典型抗精神病药物利培酮和劳拉西m口服治疗与标准肌肉注射治疗的疗效和安全性。我们假设两种治疗的功效和作用速度相似。方法：在美国的24个地点进行的一项前瞻性，平行分组，随机，盲目，非劣质性研究中，将162名表现出与活跃性精神病相关的躁动的患者随机分配为接受2 mg利培酮加2 mg口服治疗劳拉西m（N = 83）或肌肉注射5毫克氟哌啶醇加2毫克劳拉西m（N = 79）进行肌肉内治疗。主要的预后指标是阳性和阴性综合征量表上的5个项目的急性躁动群集的变化得分（晕动行为，兴奋，敌意，不合作和冲动控制不良）。该研究于2001年1月8日至8月8日进行。结果：两组的平均急性激动群集评分在基线时相似。两组在每个时间点在给药后30、60和120分钟的平均评分改善显着（p <.0001），两组均相似（p> .05）。两种治疗均耐受良好。结论：单剂量口服利培酮加劳拉西m与胃肠外给药氟哌啶醇加劳拉西m可有效控制躁动和精神病。这些发现表明，这种口服方案是目前用于急性精神病性激动的肌肉内治疗的可接受的替代方案。

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