Citation

Humble F, Berk M. Hum. Psychopharmacol. 2003; 18(6): 423-436.

Affiliation

Barwon Health Mental Health, Swanston Centre, PO Box 281, Geelong, Victoria 3220, Australia.

Copyright

(Copyright © 2003, John Wiley and Sons)

DOI

10.1002/hup.504

PMID

12923820

Abstract

The pharmacological management of violence and aggression is a common and substantial clinical dilemma in the emergency psychiatric situation. A literature search was conducted through PubMed and using the Cochrane Library. This was followed by a manual search of selected literature. Randomised controlled trials were sought that specifically addressed the acute situation, rather than the ongoing management of chronic conditions. There was a paucity of well-controlled data and insufficient evidence to support the use of many agents in emergency situations. Many studies had considerable limitations making comparison difficult. Efficacy data for a range of treatment options exists, including the use of classical and atypical anti-psychotic agents, benzodiazepines and combination therapies. Clinical risk, tolerability and environmental factors need to form part of a careful and considered judgement in the choice of treatment. Safety, tolerability and the potential for a positive experience are major considerations, thus paving the way for long term compliance.

Language: en