Psychiatr. pro Praxi, 2007; 2: 66-71

WAYS AND MEANS OF CONTROL OF AGITATED AND VIOLENT BEHAVIOR IN PSYCHIATRY PRACTICE

MUDr. Jan Vevera1, doc. MUDr. Roman Jirák CSc1, MUDr. Tereza Uhrová1, MUDr. Ilja Žukov CSc1, Mgr. Pavel Král2, MUDr. Vladislav Tichý2
1 Psychiatrická klinika 1. LF UK a VFN Praha
2 Ústřední vojenská nemocnice Praha

Authors describe a classification of agitation and violent behavior, mechanisms of its control and methods of psychological first aid and pharmacotherapy. The treatment strategies of acute/persistent nonpsychotic and acute/persistent psychotic agitation and violent behavior with benzodiazepines, antipsychotic medications, antidepressive medications, beta blockers and thymoprophylactics are further discussed.

Keywords: aggression, violence, pharmacotherapy, benzodiazepines, antipsychotics, antidepressive medications, beta blockers, thymoprophylactics

Published: April 1, 2007  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Vevera J, Jirák R, Uhrová T, Žukov I, Král P, Tichý V. WAYS AND MEANS OF CONTROL OF AGITATED AND VIOLENT BEHAVIOR IN PSYCHIATRY PRACTICE. Psychiatr. praxi. 2007;8(2):66-71.
Download citation

References

  1. Alexander J, Tharyan P, Adams C, et al. Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting. Pragmatic randomised trial of intramuscular lorazepam v. haloperidol plus promethazine Br J Psychiatry 2004; 185: 63-69. Go to original source... Go to PubMed...
  2. Anders M. Olanzapin - přehled nových poznatků. Psychiatrie 2006; 2: 94-106.
  3. Andrezina R, Marcus RN, Oren DA, Manos G, Stock E, Carson WH, McQuade RD. Intramuscular aripiprazole for the treatment of acute agitation in patients with schizophrenia or schizoaffective disorder: a double-blind, placebo-controlled comparison with intramuscular haloperidol. Psychopharmacology (Berl). 2006; 188: 281-292. Go to original source... Go to PubMed...
  4. Atakan Z, Davies T. ABC of mental health. Mental health emergencies. BMJ 1997; 314: 1740-1742. Go to original source... Go to PubMed...
  5. Battaglia J, Moss S, Rush J et al. Haloperidol, lorazepam or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study Am J Emerg Med 1997; 15: 335-340. Go to original source... Go to PubMed...
  6. Bellino S,Paradiso E, Bogetto F. Efficacy and tolerability of quetiapine in the treatment of borderline personality disorder: A pilot study. J Clin Psychiatr. 2006; 7: 1042-1046. Go to original source... Go to PubMed...
  7. Blass DM, Steinberg M, Leroi I, Lyketsos CG. Successful multimodality treatment of severe behavioral disturbance in a patient with advanced Huntington's disease. Am J Psychiatry 2001; 158: 1966-1972. Go to original source... Go to PubMed...
  8. Bond AJ. Antidepressants and human aggression. Eur J Pharmacol 2005; 526: 218-225. Go to original source... Go to PubMed...
  9. Citrome L, Casey DE, Daniel DG. et al. Adjunctive divalproex and hostility among patients with schizophrenia receiving olanzapine or risperidone. Psychiatr. Serv 2004; 55: 290-294. Go to original source... Go to PubMed...
  10. Citrome L, Volavka J, Czobor P at al. Effects of clozapine, olanzapine, risperidone, and haloperidol on hostility among patients with schizophrenia. Psychiatr Serv 2001; 52: 1510-1514. Go to original source... Go to PubMed...
  11. Cowdry RW, Gardner DL. Pharmacotherapy of borderline personality disorder: alprazolam, carbamazepine, trifluoroperazine, and trinilcypromine. Arch Gen Psychiatry 1987; 45: 111-119. Go to original source... Go to PubMed...
  12. Crowner ML. Understending and treating violent psychiatric patients. Washington DC, American Psychiatric Press, Inc., 2000.
  13. Cumming JL, Askin-Edgar S. Evidence for psychotropis effects of acetylcholinesterase inhibitors. Am J Psychiatry 2000; 13: 385-395. Go to original source...
  14. Currier GW, Chou JC, Feifel D, Bossie CA, Turkoz I, Mahmoud RA, Gharabawi GM. Acute treatment of psychotic agitation: a randomized comparison of oral treatment with risperidone and lorazepam versus intramuscular treatment with haloperidol and lorazepam. J Clin Psychiatry 2004; 65: 386-394. Go to original source... Go to PubMed...
  15. Currier GW, Medori R. Orally versus intramuscularly administered antipsychotic drugs in psychiatric emergencies. J Psychiatr Pract. 2006; 1: 30-40. Go to original source... Go to PubMed...
  16. Currier GW, Simpson GM. Risperidone liquid concentrate and oral lorazepam versus intramuscular haloperidol and intramuscular lorazepam for treatment of psychotic agitation. J Clin Psychiatry. 2001; 3: 153-157. Go to original source... Go to PubMed...
  17. Currier GW, Trenton AJ, Walsh PG, van Wijngaarden E. A pilot, open-label safety study of quetiapine for treatment of moderate psychotic agitation in the emergency setting. J Psychiatr Pract. 2006; 12: 223-228. Go to original source... Go to PubMed...
  18. De Deyn PP, Buitelaar J. Risperidone in the management of agitation and aggression associated with psychiatric disorders Eur Psychiatry 2006; 1: 21-28. Go to original source... Go to PubMed...
  19. Dietch JT & Jennings RK. (1988) Aggressivedyscontrol in patients treated with benzodiazepines. Journal of Clinical Psychiatry Psychiatry, 49: 184-188. Go to PubMed...
  20. Doubek P. Jak můžeme řešit agitovanost a neklid v ambulantní psychiatrické praxi? Psychiatr. pro Praxi. 2004; 3: 139-141.
  21. Doubek P, Hovorka J, Herman E, Nežádal T, Bajaček M, Praško J. Léčba deliria. Čes. a slov. Neurol. Neurochir. 2006; Supplementum 1: 13-19.
  22. Dostal T, Zvolsky P. Antiaggressive effect of lithium salts in severe mentally retardet adolescents. International Psychofarmakology 1970; 5: 203-207. Go to original source...
  23. Franco KN, Messinger-Rapport B. Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. J Am Med Dir Assoc 2006; 3: 201-202. Go to original source... Go to PubMed...
  24. Haverkamp W, Breithardt G and Camm A.J. et al., The potential for QT prolongation and proarrhythmia by non-anti-arrhythmic drugs: clinical and regulatory implications. Report on a Policy conference of the European Society of Cardiology, Cardiovasc Res 2000; 47: 219-233. Go to original source... Go to PubMed...
  25. Kao LW, Kirk MA, Evers SJ, Rosenfeld SH. Droperidol, QT prolongation, and sudden death: what is the evidence? Ann Emerg Med 2003; 41: 546-558. Go to original source... Go to PubMed...
  26. Kerr IB, Taylor DM. Acute disturbed or violent behaviour: principles of treatment. J Psychopharmacol 1997; 11: 271-277. Go to original source... Go to PubMed...
  27. Krakowski MI, Czobor P, Citrome L, Bark N, Cooper TB. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 2006; 63: 622-629. Go to original source... Go to PubMed...
  28. Lejeune J, Larmo I, Chrzanowski W, Witte R, Karavatos A, Schreiner A, Lex A, Medori R. Oral risperidone plus oral lorazepam versus standard care with intramuscular conventional neuroleptics in the initial phase of treating individuals with acute psychosis. Int Clin Psychopharmacol 2004; 5: 259-269. Go to original source... Go to PubMed...
  29. Lonergan ET, Cameron M, Luxenberg J. Valproic acid for agitation in dementia. Cochrane Database Syst Rev. 2004; (2): CD003945). Go to original source...
  30. Longeran E, Luxenberg J, Colford J. Haloperidol for agitation in dementia. Cochrane Database Syst Rev. 2002; 2: CD002852. Go to original source...
  31. Malá E. Agrese u dětí a adolescentů. Psychiatrie pro praxi. 2005; 1: 7-10.
  32. Marin DB, Greenwald BS. Carbamazepine for aggressive agitation in demented patients during nursing care.Am J Psychiatry1989; 146: 805. Go to original source... Go to PubMed...
  33. McAllister - Williams RH, Ferrier IN. Rapid tranquillisation: time for a reappraisal of options for parenteral therapy. Br. J. Psychiatry 2002; 180: 485-489. Go to original source... Go to PubMed...
  34. Miczek KA, Weerts E, Haney M, Tidey J. Neurobiological mechanisms controlling aggression: preclinical developments for pharmacotherapeutic interventions. Neurosci Biobehav Rev. 1994; 18: 97-110. Go to original source... Go to PubMed...
  35. Mohr P. Antipsychotika druhé generace v léčbě akutní psychotické agitovanosti. Psychiatrie pro praxi 2003; 2: 62-65.
  36. Mohr P. Olanzapin v léčbě akutní agitovanosti. Psychiatrie pro praxi 2004; 3: 273-277.
  37. Nobay F, Simon BC, Levitt MA. A prospective, double-blind, randomized trial of midazolam versus haloperidol versus lorazepam in the chemical restraint of violent and severely agitated patients. Acad Emerg Med 2004; 11: 744-749. Go to original source...
  38. Patterson JF. A preliminary study of carbamazepine in the treatment of assaultive patients with dementia. J Geriatr Psychiatry Neurol 1988; 1: 21-23. Go to original source... Go to PubMed...
  39. Patterson JF. Carbamazepine for assaultive patients with organic brain disease. Psychosomatics. 1987; 28: 579-581. Go to original source... Go to PubMed...
  40. Ranjan S, Chandra PS, Alexander J, Tharyan P, Adams C, John T, Mol C, Philip J. Drug combinations for rapid tranquillisation Authors' reply. Br. J. Psychiatry 2005; 187: 192-193. Go to original source... Go to PubMed...
  41. Rothschild AJ. Shindul-Rothschild JA, Viguera A, et al. Comparison of the frequency of behavioral disinhibition on alprazolam, clonazepam, or no benzodiazepine in hospitalized psychiatric patients. Journal of Clinical Psychopharmacology 2000; 20, 7-11. Go to original source... Go to PubMed...
  42. Raboch J, Anders M, Praško J, Hellerová P. Psychiatrie. Doporučené postupy psychiatrické péče II. Infopharm 2006; 204 s.
  43. Seifertová D, Praško J, Höschl C. Postupy v léčbě psychických poruch. Academia Medica Pragensis 2004; 479 s.
  44. Sink KM, Holden KF, Yaffe K. Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA. 2005; 5: 596-608. Go to original source... Go to PubMed...
  45. Sobin P, Schneider L, McDermott H. Fluoxetine in the treatment of agitated dementia. Am J Psychiatry1989; 146: 1636. Go to original source...
  46. Sherad MH, Marini JL, Bridges CI, Wagner E. The effect of lithium on impulsive aggressive behavior in man. Am J Psychiatry 1976; 12: 1409-1413. Go to original source...
  47. Tariot PN, Erb R, Podgorski CA, et al. Efficacy and tolerability of carbamazepine for agitation and aggresion in dementia. Am J Psychiatry 1998; 155; 54-60. Go to original source... Go to PubMed...
  48. Taylor D, Paton C, Kerwin R. The Maudsley 2005-2006 Prescribing Guidelines. 8th edition. Taylor&Francis 2005; 383 s. Go to original source...
  49. TREC Collaborative Group. Rapid tranquillisation for agitated patients in emergency psychiatric rooms: a randomised trial of midazolam versus haloperidol plus promethazine. BMJ 2003; 327: 708-713. Go to original source... Go to PubMed...
  50. Vevera J, Hubbard A, Veselý A, Papežová H, Violent behavior in schizophrenia: retrospective study of four independent samples from Prague 1949 to 2000, British Journal of Psychiatry, 2005; 187: 426-430. Go to original source... Go to PubMed...
  51. Vevera J, Jirák R, Uhrová T, Žukov I. Možnosti farmakologického ovlivnění násilného chování u pacientů s demencí. CS Psychiatrie 2003; 3: 142-144.
  52. Vevera J, Papežova H, Ort M, Žukov I. Prevalance násilí na psychiatrické klinice 1. LF UK a VFN v roce 2000. Psychiatrie v medicíně a medicína v psychiatrii. (eds. Raboch J, Doubek P, Zrzavecká I) Galen 2002. p. 277.
  53. Vevera J, Uhrová T, Jirák R.Žukov I, Ort V. Násilné chování a možnosti jeho ovlivnění (I) výskyt, rozdělení a klinické koreláty. Psychiatrie pro praxi 2002; 5: 40-43.
  54. Vevera J, Uhrová T, Jirák R, Žukov I, Stopka P, Ort V. Násilné chování a možnosti jeho ovlivnění II. díl, neurotransmitery a farmakoterapie. Psychiatrie pro praxi 2002; 6: 17-21.
  55. Vodáčková D a kol., Krizová intervence, Portál, Praha, 2002.
  56. Volavka J. Neurobiology of Violence 2nd. ed. American Psychiatric Publishing, Washington, DC 2002; 388 s.
  57. Volavka J, Czobor P, Nolan K, Sheitman B, Lindenmayer JP, Citrome L, McEvoyJP, Cooper TB, Lieberman JA. Overt aggression and psychotic symptoms in patients with schizophrenia treated with clozapine, olanzapine, risperidone, orhaloperidol. J Clin Psychopharmacol 2004; 24: 225-228. Go to original source... Go to PubMed...
  58. Wilcox J. Divalproex sodium in the treatment of aggressive behavior. Ann Clin Psychiatry. 1994; 6: 17-20. Go to original source... Go to PubMed...
  59. Wooltorton E. Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials, CMAJ 2002; 167: 1269-1270. Go to PubMed...
  60. Wooltorton E Olanzapine (Zyprexa): increased incidence of cerebrovascular events in dementia trials. CMAJ. 2004; 9: 1395. Go to original source... Go to PubMed...
  61. Wyant M, Diamond B, O'Neal E, et al. The use of midazolam in acutely agitated psychiatric patients. Psychopharmacol Bull 1990; 26: 126-129. Go to PubMed...
  62. Žukov I, Vevera J, Morcinek T. Farmakologické ovlivnění násilí. 42. Česko-slovenská psychofarmakologická konference. Sborník abstrakt, Galen 2000; s. 148.




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.