Pharmacological Management of Acutely Agitated Schizophrenic Patients

Agitation is commonly seen in acute schizophrenic patients and core symptoms include a wide range of symptom. It requires rapid and effective treatment approaches in order to protect patient and caregiver from potential injury. Clinician's decision of pharmacological treatment should be individualized to the needs and circumstances of the patient. Benzodiazepines, typical antipsychotics, and combinations of typical antipsychotics and benzodiazepines have been widely used as treatment options. Atypical antipsychotics have clear advantages over the typical drugs as they generally show a much better safety and tolerability profile, particularly to EPS and related side effects, however clinical perception regarding efficacy in treating acutely agitated psychotic patient is controversial. New intramuscular atypical antipsychotic formulations offer evidence of being at least as effective as typical antipsychotics in controlling agitation. Therefore, they should be considered as first line therapy in agitated schizophrenic patients.