Treatment of Behavioral Emergencies: A Summary of the Expert Consensus Guidelines

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

“…[14][15][16] Historically, traditional agents have been used as first-line medications for the treatment of acutely agitated patients, in part because of the availability of parenteral preparations. However, because of the recent introduction of parenteral forms of atypical the ziprasione (4.1; SD = 1.0), haloperidol plus promethazine (2.2; SD = 0.7), haloperidol (1.4; SD = 0.1) and olanzapine groups (0.5; SD = 0.2), (p = 0.001).…”

“…4,24 Many patients perceive parenteral administration as coercive and abusive, and 93% of patients rank oral formulations as their preferred treatment option during a behavioral emergency. 15 Midazolam's half-life is two to three hours with a duration of action generally up to 120 minutes. Some adverse effects are associated with the IM use of midazolam, including amnesia, respiratory depression, paradoxical reactions and confusion.…”

La médication psychiatrique comme contention : entre autonomie et protection, quelle place pour un cadre juridique ?

“…Pourtant, bien que la littérature scientifique sur l'isolement et les contentions soit abondante (Larue et al, 2009 ;Knutzen et al, 2007 ;Pollard et al, 2007), peu de chercheurs, de cliniciens, d'éthi -ciens ou de juristes s'intéressent à la question de la contention chimique (Currier, 2003).…”

“…En effet, la contention chimique serait perçue comme moins invasive, alors que l'isolement et les contentions seraient vécus comme une punition (Wynn, 2002). Par ailleurs, son usage semble être assez courant 3 , d'autant plus que la contention physique n'est que rarement appliquée sans médication, consentie ou non (Currier, 2003). Ainsi, si une volonté affirmée de réduire, voire d'éliminer, le recours à l'isolement et aux contentions est manifeste (Grigg, 2006 ;Morin et Michaud, 2003), il semblerait que l'on ne puisse pas en dire autant pour la contention chimique, considérée comme un moindre mal.…”

Haloperidol mais prometazina para pacientes agitados - uma revisão sistemática

“…TREC-Rio-II compara esta combinação com o haloperidol isolado do uso da prometazina. O uso isolado de haloperidol é amplamente recomendado por manuais importantes nos EUA 17 e Reino Unido 16 . Com a combinação HP administrada a 510 pacientes nestes quatro estudos, este tratamento tornou-se o mais avaliado para o manejo da agitação e agressão em ensaios clínicos randomizados.…”