Oral risperidone, olanzapine and quetiapine versus haloperidol in psychotic agitation.
OBJECTIVE
Acute agitation is a common presentation in emergency departments and is often secondary to an underlying psychotic condition. The aim of this study was to compare the effectiveness of three second generation antipsychotics (risperidone, olanzapine, quetiapine) versus haloperidol in the treatment of psychotic agitation for up to 72 h.


METHODS
We recruited 101 patients with acute psychosis who were admitted at the Mental Health Department 1 South of Turin, Psychiatric Emergency Service of San Giovanni Battista Hospital, from June 2004 to June 2005.


RESULTS
Aggressive behavior, as measured by Modified Overt Aggression Scale and Hostility-suspiciousness factor derived from the Brief Psychiatric Rating Scale, significantly improved in all groups, with no significant between-group differences. Extrapyramidal symptoms were more common in haloperidol treated patients compared with patients receiving risperidone, olanzapine or quetiapine.


CONCLUSIONS
Our results show that in the clinical practice setting of emergency psychiatry olanzapine, risperidone, quetiapine are as effective as haloperidol and better tolerated.
Villari
Vincenzo
V
Emergency Department, Psychiatric Emergency Service, S. Giovanni Hospital, Corso Bramante 88, 10126 Turin, Italy.
Rocca
Paola
P
Fonzo
Valeria
V
Montemagni
Cristiana
C
Pandullo
Pasquale
P
Bogetto
Filippo
F
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000453:epidemiology; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use; D004637:Emergency Services, Psychiatric / Q000379:methods; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006791:Hostility; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000523:psychology; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology*; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine