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KMID : 1177220090120010042
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Korean Journal of Schizophrenia Research
2009 Volume.12 No. 1 p.42 ~ p.48
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The Effect of Intramuscular Olanzapine in the Treatment of Acute Agitation
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Jeon Dong-Wook
Kim Young-Hoon
Shim Joo-Cheol
Kong Bo-Geum
Lee Sang-Kyung
Yoon Sung-Wook
Moon Jung-Joon
Kim Jeong-Eun
Baek Jun-Hyung
Kim Woo-Jin
Kim Min-Hyo
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Abstract
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Introduction：Acutely agitated patients present with intense symptoms and potentially violent behavior that may place them at great risk. Recently several studies reported that intramuscular (IM) olanzapine has shown to be an effective for treating them. In this study, we compared the effect of IM olanzapine with IM haloperidol or IM haloperidol plus lorazepam on acute agitation.
Methods：In a 2-hour, randomize and open labeled study, hospitalized patients with acute psychotic symptom in association with psychotic disorders and bipolar disorder defined by DSM-IV TR were randomly assigned to one of three groups；1) olanzapine 10 mg IM (n=15), 2) haloperidol 5 mg IM (n=15), 3) haloperidol 5 mg+lorazepam 4 mg IM (n=15). Acute agitation was defined both two criteria：1) >14 scores in sum of, 2) >4 scores in any item of PANSS-excitement component (PANSS-EC). The PANSS-EC (excitement component), Clinical Global Impression-Severity, behavioral activity rating scale were assessed at baseline, 30, 60 and 120 minutes after first injection.
Results：No significant differences in baseline demographics and clinical characteristics were found among three groups. Although all three groups showed significantly decrement of PANSS-EC scores at 2 hours compared to baseline (time effect) (p<0.0001). However, no significant difference in PANSS-EC scores was found among groups. No serious adverse event was found in all three groups.
Conclusion：Olanzapine IM was effective in treating acutely agitated psychotic patients without serious treatment-emergent adverse events. However, no significant advantage of olanzapine IM was found over haloperidol IM alone or haloperidol+lorazepam IM.
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KEYWORD
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Acute agitation, Psychosis, Intromuscular antipsychotics
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