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Use of inhaled loxapine in acute psychiatric agitation

Published online by Cambridge University Press:  23 March 2020

S. Ovejero*
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
M. Iza
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
S. Vallejo
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
C. Vera
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
A. Sedano
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
R. Álvarez
Affiliation:
Hospital Universitario Rey Juan Carlos, Psychiatry, Móstoles, Spain
L. Mata
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
S. Sánchez-Alonso
Affiliation:
Hospital Universitario Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
*
*Corresponding author.

Abstract

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Objectives

The aim of this work is to study the efficacy of loxapine inhalation powder on agitated patients in a psychiatric inpatient unit.

Methods

Nineteen patients sample, with an average age of 39.4 years old, diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder. Patients inhaled loxapine 10 mg, using the staccato system, when they suffered a psychomotor agitation. The clinical efficacy was measured as a change from baseline in the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) and in the Young Mania Rating Scale (YMRS) one hour after the administration of loxapine.

Results

A mean of 9.8 points reduction (22.6 at baseline and 12.7 one hour after the administration) was found on the PANSS-EC (t-test, P < .001) and 68.4% of the patients were considered responders as they obtained a reduction of at least 40% of the basal score. On 10 of the total of the agitated patients showed an improvement of the psychomotor excitement, and this allowed the clinicians to remove the physical restraint; on 6 of the agitated patients the physical restraint could be avoided during the whole treatment; and 3 of the patients experienced a reduction of the excitement. The reduction on PANNS-EC on the latest group was not statistically significant (t-test, P = .121).

Conclusions

Inhaled loxapine was a non-invasive, rapid and effective alternative treatment for acute agitation in a psychiatric inpatient unit. It resulted more effective on mild and moderate cases; not been significantly effective on the severe cases of agitation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW446
Copyright
Copyright © European Psychiatric Association 2014
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