Intramuscular olanzapine in patients with borderline personality disorder: an observational study in an emergency room

Rapid tranquilization for agitated patients in emergency psychiatric rooms: a randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone

“…4 Some clinical trials among patients with acute agitation associated with schizophrenia have demonstrated that the IM formulations of atypical antipsychotics provide similar efficacy to those of conventional antipsychotics, albeit without the associated high incidence of extra-pyramidal side effects (EPS). 14,37,[41][42][43] Short-term treatment with atypical antipsychotics offers improvements over haloperidol. In a seven-day randomized, open-label multicenter international study, the efficacy of IM ziprasidone (10mg initially, then 5 to 20mg every 4 to 6 hours, up to a maximum daily dose of 80mg; n = 90) was compared with that of IM haloperidol (2.5 to 10mg, up to a maximum daily dose of 40mg; n = 42) in the treatment of hospitalized patients with acute psychotic agitation.…”

Intramuscular olanzapine vs. intramuscular short-acting antipsychotics: safety, tolerability and the switch to oral antipsychotic medication in patients with schizophrenia or acute mania

“…Although the overall efficacy of the different classes of parenteral agents is similar, randomised controlled trials (RCTs) have shown that intramuscular (IM) olanzapine is associated with a more immediate onset of action than IM lorazepam in bipolar mania (5), and that patients treated with IM olanzapine have significantly less extrapyramidal symptoms and require less oral anticholinergic medication than patients treated with IM haloperidol for schizophrenia (6,7). However, comparison of the efficacy and tolerability of IM antipsychotic medications for treatment of patients with acute agitation in RCTs with strict inclusion criteria and limited use of concomitant medication may not reflect the more severely ill patients who attend real‐life emergency departments (8–11).…”

Potential Complications of Combining Intramuscular Olanzapine with Benzodiazepines in Emergency Department Patients

“…Safety concerns have been raised by some authors about use of olanzapine ϩ benzodiazepine, and the manufacturer's package insert urges caution as this combination has not been well studied (3,12). Although some studies have documented asymptomatic decreases in blood pressure, only one case report has noted symptomatic hypotension with combination use (13,17).…”