Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach
Objective: To present the essential guidelines for pharmacological management of patients with psychomotor agitation in Brazil. Methods: This is a systematic review of articles retrieved from the MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and SciELO databases published from 1997 to...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Associação Brasileira de Psiquiatria (ABP)
2019-03-01
|
| Series: | Brazilian Journal of Psychiatry |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462019005005102&lng=en&tlng=en |
| _version_ | 1818910303654510592 |
|---|---|
| author | Leonardo Baldaçara Alexandre P. Diaz Verônica Leite Lucas A. Pereira Roberto M. dos Santos Vicente de P. Gomes Júnior Elie L.B. Calfat Flávia Ismael Cintia A.M. Périco Deisy M. Porto Carlos E.K. Zacharias Quirino Cordeiro Antônio Geraldo da Silva Teng C. Tung |
| author_facet | Leonardo Baldaçara Alexandre P. Diaz Verônica Leite Lucas A. Pereira Roberto M. dos Santos Vicente de P. Gomes Júnior Elie L.B. Calfat Flávia Ismael Cintia A.M. Périco Deisy M. Porto Carlos E.K. Zacharias Quirino Cordeiro Antônio Geraldo da Silva Teng C. Tung |
| author_sort | Leonardo Baldaçara |
| collection | DOAJ |
| description | Objective: To present the essential guidelines for pharmacological management of patients with psychomotor agitation in Brazil. Methods: This is a systematic review of articles retrieved from the MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and SciELO databases published from 1997 to 2017. Other relevant articles in the literature were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: Of 5,362 articles retrieved, 1,731 abstracts were selected for further reading. The final sample included 74 articles that met all inclusion criteria. The evidence shows that pharmacologic treatment is indicated only after non-pharmacologic approaches have failed. The cause of the agitation, side effects of the medications, and contraindications must guide the medication choice. The oral route should be preferred for drug administration; IV administration must be avoided. All subjects must be monitored before and after medication administration. Conclusion: If non-pharmacological strategies fail, medications are needed to control agitation and violent behavior. Once medicated, the patient should be monitored until a tranquil state is possible without excessive sedation. Systematic review registry number: CRD42017054440. |
| first_indexed | 2024-12-19T22:40:40Z |
| format | Article |
| id | doaj.art-29bef73f09964f65b72ebbf5bbea32c0 |
| institution | Directory Open Access Journal |
| issn | 1809-452X |
| language | English |
| last_indexed | 2024-12-19T22:40:40Z |
| publishDate | 2019-03-01 |
| publisher | Associação Brasileira de Psiquiatria (ABP) |
| record_format | Article |
| series | Brazilian Journal of Psychiatry |
| spelling | doaj.art-29bef73f09964f65b72ebbf5bbea32c02022-12-21T20:03:05ZengAssociação Brasileira de Psiquiatria (ABP)Brazilian Journal of Psychiatry1809-452X2019-03-01010.1590/1516-4446-2018-0177S1516-44462019005005102Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approachLeonardo BaldaçaraAlexandre P. DiazVerônica LeiteLucas A. PereiraRoberto M. dos SantosVicente de P. Gomes JúniorElie L.B. CalfatFlávia IsmaelCintia A.M. PéricoDeisy M. PortoCarlos E.K. ZachariasQuirino CordeiroAntônio Geraldo da SilvaTeng C. TungObjective: To present the essential guidelines for pharmacological management of patients with psychomotor agitation in Brazil. Methods: This is a systematic review of articles retrieved from the MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and SciELO databases published from 1997 to 2017. Other relevant articles in the literature were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: Of 5,362 articles retrieved, 1,731 abstracts were selected for further reading. The final sample included 74 articles that met all inclusion criteria. The evidence shows that pharmacologic treatment is indicated only after non-pharmacologic approaches have failed. The cause of the agitation, side effects of the medications, and contraindications must guide the medication choice. The oral route should be preferred for drug administration; IV administration must be avoided. All subjects must be monitored before and after medication administration. Conclusion: If non-pharmacological strategies fail, medications are needed to control agitation and violent behavior. Once medicated, the patient should be monitored until a tranquil state is possible without excessive sedation. Systematic review registry number: CRD42017054440.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462019005005102&lng=en&tlng=enPsychomotor agitationaggressiontranquilizing agentsemergencymental disorders |
| spellingShingle | Leonardo Baldaçara Alexandre P. Diaz Verônica Leite Lucas A. Pereira Roberto M. dos Santos Vicente de P. Gomes Júnior Elie L.B. Calfat Flávia Ismael Cintia A.M. Périco Deisy M. Porto Carlos E.K. Zacharias Quirino Cordeiro Antônio Geraldo da Silva Teng C. Tung Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach Brazilian Journal of Psychiatry Psychomotor agitation aggression tranquilizing agents emergency mental disorders |
| title | Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach |
| title_full | Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach |
| title_fullStr | Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach |
| title_full_unstemmed | Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach |
| title_short | Brazilian guidelines for the management of psychomotor agitation. Part 2. Pharmacological approach |
| title_sort | brazilian guidelines for the management of psychomotor agitation part 2 pharmacological approach |
| topic | Psychomotor agitation aggression tranquilizing agents emergency mental disorders |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462019005005102&lng=en&tlng=en |
| work_keys_str_mv | AT leonardobaldacara brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT alexandrepdiaz brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT veronicaleite brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT lucasapereira brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT robertomdossantos brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT vicentedepgomesjunior brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT elielbcalfat brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT flaviaismael brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT cintiaamperico brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT deisymporto brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT carlosekzacharias brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT quirinocordeiro brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT antoniogeraldodasilva brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach AT tengctung brazilianguidelinesforthemanagementofpsychomotoragitationpart2pharmacologicalapproach |