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Treatment of acute behavioural disturbance: a UK national survey of rapid tranquillisation

Published online by Cambridge University Press:  09 June 2006

Stephen Pereira ,
Carol Paton ,
Lucy M Walkert ,
Susan Shaw ,
Richard Gray  and
Hiram Wildgust
Stephen Pereira
Affiliation:
Consultant Psychiatrist Pathways PICU, Goodmayes Hospital, Essex & Hon Senior Lecturer Guys, Kings & St Thomas School of Medicine, London
Carol Paton
Affiliation:
Chief Pharmacist, Oxleas NHS Trust, Bexley, Kent
Lucy M Walkert
Affiliation:
Psychologist, Pathways PICU, Goodmayes Hospital, Essex
Susan Shaw
Affiliation:
Consultant Psychiatrist, West Middlesex University Hospital
Richard Gray
Affiliation:
Fellow in Health Services Research, Institute of Psychiatry, London
Hiram Wildgust
Affiliation:
Therapeutic Advisor Psychosis, Eli Lilly & Co Ltd
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Abstract

Rapid Tranquillisation (RT), defined as “the use of psychotropic medication to control agitated, threatening or destructive psychotic behaviour”, is a last resort pharmacological intervention. The withdrawal of the widely used droperidol in 2001 due to concerns over QTc prolongation may have increased the variability in RT practice across the UK. This paper reports on a UK wide survey of the practice of RT by psychiatrists. The survey pre-dated publication of NICE guidance on management of distributed behaviour. 257 questionnaires were received (response rate 22%). In comparison with previous surveys of this type, the overall quality of prescribing and monitoring has improved, although some apparently idiosyncratic practice remains. The majority of psychiatrists expressed concerns about prescribing and monitoring RT and would welcome an easy to use algorithm and associated training package. Findings are discussed in terms of training implications and BNF recommendations for high dose prescribing.

Keywords

Rapid TranquillisationUK National Survey
Type
Original Paper
Information
Journal of Psychiatric Intensive Care , Volume 1 , Issue 2 , December 2005 , pp. 84 - 88
Copyright
© 2006 NAPICU

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