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Rapid Tranquillisation

A Survey of Emergency Prescribing in a General Psychiatric Hospital

Published online by Cambridge University Press:  02 January 2018

L. S. Pilowsky ,
H. Ring ,
P. J. Shine ,
M. Battersby  and
M. Lader
L. S. Pilowsky*
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5 8AF
H. Ring
Affiliation:
National Hospital for Nervous Diseases, Queen's Square, London W1
P. J. Shine
Affiliation:
Clinical Psychopharmacology Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
M. Battersby
Affiliation:
Flinders Medical Centre, Bedford Park, Adelaide, South Australia
M. Lader
Affiliation:
University of London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
*
∗Correspondence
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Abstract

Rapid tranquillisation – giving a psychotropic to control behavioural disturbances – is common in medical practice, yet few surveys describe its use in psychiatric populations. Over five months, 102 incidents, involving 60 patients, were retrospectively surveyed. Patients most often involved were young white men. The commonest diagnosis was affective disorder (manic phase) (39%) followed by schizophrenia (33%). Fifteen patients were involved in 57% of the incidents. The majority of incidents involved injury to people or damage to property. The most frequently used drugs were diazepam and haloperidol, alone or in combination. Droperidol, chlorpromazine, sodium amytal and paraldehyde were rarely used. Diazepam alone or in combination with haloperidol delivered intravenously was most rapidly effective and was associated with greatest staff satisfaction. Serious side-effects were rare.

Type
Papers
Information
The British Journal of Psychiatry , Volume 160 , Issue 6 , June 1992 , pp. 831 - 835
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Angold, A. (1989) Seclusion. British Journal of Psychiatry, 154, 437–444.CrossRefGoogle Scholar
British National Formulary (1989) British National Formulary, Number 16. London: The British Medical Association and The Pharmaceutical Press.Google Scholar
Brizer, D., Convit, A., Krakowski, M., et al (1987) A rating scale for reporting violence on psychiatric wards. Hospital and Community Psychiatry, 38, 769–770.Google ScholarPubMed
Clinton, J. E., Sterner, S., Stelmachers, Z., et al (1987) Haloperidol for sedation of disruptive emergency patients. Annals of Emergency Medicine, 16, 319–322.CrossRefGoogle ScholarPubMed
Cooper, S. J., Browne, F. W. A., McClean, K. J., et al (1983) Aggressive behaviour in a psychiatric observation ward. Acta Psychiatrica Scandinavica, 68, 386–393.CrossRefGoogle Scholar
Dubin, W. R. (1988) Rapid tranquillisation: antipsychotics or benzodiazepines. Journal of Clinical Psychiatry, 49 (suppl. 12), 5–12.Google ScholarPubMed
Ellison, J., Hughes, D. & Kimberly, A. W. (1989) An emergency psychiatry update. Hospital and Community Psychiatry, 40, 250–260.Google ScholarPubMed
Goldberg, R. J., Dubin, W. R. & Fogel, B. S. (1989) Review. Behavioural emergencies, assessment of psychopharmacologic management. Clinical Neuropharmacology, 12, 233–248.CrossRefGoogle ScholarPubMed
Haller, R. M. & Deluty, R. H. (1988) Assaults on staff by psychiatric inpatients, a critical review. British Journal of Psychiatry, 152, 174–179.CrossRefGoogle ScholarPubMed
Lerner, Y., Lwow, E., Levitin, A., et al (1979) Acute high dose parenteral haloperidol treatment of psychosis. American Journal of Psychiatry, 136, 1061–1065.Google ScholarPubMed
McLaren, S., Browne, F. W. A. & Taylor, P. J. (1990) A study of psychotropic medication given ‘as required’ in a regional secure unit. British Journal of Psychiatry, 156, 732–735.CrossRefGoogle Scholar
Modell, J. G., Lenox, R. H. & Weiner, S. (1985) Inpatient clinical trial of lorazepam for the treatment of manic agitation. Journal of Clinical Psychopharmacology, 5, 109–113.CrossRefGoogle ScholarPubMed
Neff, K., Denny, D. & Blachly, P. (1972) Control of severe agitation with droperidol. Diseases of the Nervous System, 33, 594–597.Google ScholarPubMed
Noble, P. & Rodgers, S. (1989) Violence by psychiatric in-patients. British Journal of Psychiatry, 155, 384–390.CrossRefGoogle ScholarPubMed
Palmstierna, T. & Wistedt, B. (1987) Staff observation aggression scale, SOAS. Presentation and evaluation. Acta Psychiatrica Scandinavica, 76, 657–663.CrossRefGoogle ScholarPubMed
Rapp, M. S. (1987) Chemical restraint. Canadian Journal of Psychiatry, 32, 20–21.CrossRefGoogle ScholarPubMed
Resnick, M. & Burton, B. J. (1984) Droperidol vs. haloperidol in the initial management of acutely agitated patients. Journal of Clinical Psychiatry, 45, 298–299.Google ScholarPubMed
Sheard, M. H. (1988) Review: clinical pharmacology of aggressive behaviour. Clinical Pharmacology, 11, 483–492.Google Scholar
Tardiff, K. & Sweillam, A. (1980) Assault, suicide and mental illness. Archives of General Psychiatry, 37, 164–169.CrossRefGoogle ScholarPubMed
Tuason, V. B. (1986) A comparison of parenteral loxapine and haloperidol in hostile and aggressive acutely schizophrenic patients. Journal of Clinical Psychiatry, 47, 126–129.Google ScholarPubMed
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Yesavage, J. A. (1982) Inpatient violence and the schizophrenic patient: an inverse correlation between danger related events and neuroleptic levels. Biological Psychiatry, 17, 1331–1337.Google ScholarPubMed
Yudofsky, S. C., Silver, J. M., Jackson, W., et al (1986) The overt aggression scale for the objective rating of verbal and physical aggression. American Journal of Psychiatry, 143, 35–39.Google ScholarPubMed
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