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  • 标题:Conventional intramuscular sedatives versus ziprasidone for severe agitation in adolescents: case-control study
  • 本地全文:下载
  • 作者:William C Jangro ; Horacio Preval ; Robert Southard
  • 期刊名称:Child and Adolescent Psychiatry and Mental Health
  • 印刷版ISSN:1753-2000
  • 电子版ISSN:1753-2000
  • 出版年度:2009
  • 卷号:3
  • 期号:1
  • 页码:9
  • DOI:10.1186/1753-2000-3-9
  • 语种:English
  • 出版社:BioMed Central
  • 摘要:

    Objective

    The objective of this study was to compare intramuscular (IM) ziprasidone to conventional IM medications (haloperidol combined with lorazepam) for the treatment of severe agitation in adolescents (age 12–17).

    Methods

    We retrospectively identified consecutive severe agitation episodes (defined as requiring physical restraint) in adolescents treated with either IM ziprasidone or conventional IM agents in a psychiatric emergency room. For ziprasidone, the dosage was 20 mg for 23 episodes and 10 mg for 5 episodes. For 24 episodes treated with combined haloperidol and lorazepam, the dosages were 4.8 ± 0.3 SEM mg and 1.9 ± 0.4 mg respectively. Outcomes were the duration of restraint and need for adjunctive "rescue" medications within 60 minutes. These outcomes were decided prior to reviewing any records.

    Results

    No difference was found in restraint duration (ziprasidone, N = 28, 55 ± 5 minutes; haloperidol with lorazepam N = 24, 65 ± 7 minutes, P = NS). Use of "rescue" medications did not differ between the two groups. No changes in blood pressure were found, but pulse decreased 8.3 ± 2.4 for haloperidol with lorazepam and 8.9 ± 4.24 for ziprasidone (P = NS). No instances of excessive sedation or extra-pyramidal symptoms were documented.

    Conclusion

    In this study, IM ziprasidone appeared effective, well tolerated, and similar in clinical profile to combined conventional IM medications for treating severe agitation in adolescents. Given the reportedly favorable acute side effect profile of parenteral atypical agents, they may provide an alternative to conventional antipsychotics for treating acute agitation in both adult and adolescent populations. Future randomized, controlled studies are needed.

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