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. 2021 Nov 8;11(6):334-346.
doi: 10.9740/mhc.2021.11.334. eCollection 2021 Nov.

Managing acute agitation and aggression in the world of drug shortages

Jennifer Miller

Managing acute agitation and aggression in the world of drug shortages

Jennifer Miller. Ment Health Clin. .

Abstract

Acute agitation and aggression create safety risks for both patients and staff, often leading to psychiatric emergencies. Quick and appropriate treatment is necessary to achieve safe and effective outcomes. Unfortunately, there are several factors that hinder timely interventions, such as medication shortages and delay in staff preparedness. Ultimately, the goal of managing acute agitation and aggression in the clinical setting is to de-escalate the situation and prevent harm to patients and staff. This article will explore useful interventions in realizing treatment goals for the management of agitation and aggression in adults while navigating limitations faced in practice.

Keywords: aggression; agitation; benzodiazepines; de-escalation; first-generation antipsychotics; medication shortage; second-generation antipsychotics.

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Conflict of interest statement

Disclosures: I have nothing personal to disclose. Psychopharmacology Pearls are review articles intended to highlight both the evidence base available and/or controversial areas of clinical care for psychiatric and neurologic conditions as well as strategies of clinical decision-making used by expert clinicians. As pearls, articles reflect the views and practice of each author as substantiated with evidence-based facts as well as opinion and experience. Articles are edited by members of the Psychopharmacology Pearls Editorial Board as well as peer reviewed by MHC reviewers. This article was developed as part of the 2021 Psychopharmacology Pearls product for BCPP recertification credit. The course information and testing center is at https://cpnp.org/459431.

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Washington: American Psychiatric Association;; 2013.
    1. Roberts J, Gracia Canales A, Blanthorn-Hazell S, Craciun Boldeanu A, Judge D. Characterizing the experience of agitation in patients with bipolar disorder and schizophrenia. BMC Psychiatry. 2018;18(1):104. 10.1186/s12888-018-1673-3 PubMed PMID: 29661160. - DOI - PMC - PubMed
    1. Schleifer JJ. Management of acute agitation in psychosis: an evidence-based approach in the USA. Adv Psychiatr Treat. 2011;17(2):91–100. doi: 10.1192/apt.bp.109.007310. - DOI
    1. Meyer JM, Cummings MA, Proctor G, Stahl SM. Psychopharmacology of persistent violence and aggression. Psychiatr Clin North Am. 2016;39(4):541–56. 10.1016/j.psc.2016.07.012 PubMed PMID: 27836150. - DOI - PubMed
    1. Allen MH, Currier GW. Use of restraints and pharmacotherapy in academic psychiatric emergency services. Gen Hosp Psychiatry. 2004;26(1):42–9. 10.1016/j.genhosppsych.2003.08.002 PubMed PMID: 14757302. - DOI - PubMed

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