clopenthixol-acetate-ester and Psychomotor-Agitation

A double-blind controlled trial was carried out in 73 hospitalized elderly patients to evaluate the effect of different low doses of the neuroleptic, zuclopenthixol, on behavioural disorders associated with dementia. Patients were randomized into four groups and received treatment for 4 weeks with fixed daily doses of 2 mg, 4 mg or 6 mg zuclopenthixol, or with a dose which could be increased from 4 mg to 20 mg daily. The dose could also be reduced if necessary. Fifty-four of the patients remained on the same daily dose throughout the study. The results of symptom assessments showed that there was a significant improvement from baseline scores in all of the dose groups and, with the exception of patients on 2 mg daily, this was evident after only 1 week of treatment. Although improvement was noted in all the symptoms evaluated, the best effect was achieved on aggressive behaviour, restlessness/agitation, sleep disorders, and shouts/torments others. Only a few, relatively mild side-effects were recorded and there was no increase in frequency with increasing doses. There was significant correlation between the serum concentration and the dose of zuclopenthixol used but not in connection to age and clinical efficacy.

Topics: Aged; Aged, 80 and over; Aggression; Antipsychotic Agents; Clopenthixol; Dementia; Double-Blind Method; Drug Administration Schedule; Female; Hospitalization; Humans; Male; Psychomotor Agitation; Random Allocation

Many psychotic patients are treated with antipsychotic medications during acute agitation and aggressive behavior episodes in an attempt to achieve a rapid calming effect. Those medications include olanzapine, zuclopenthixol acetate, and haloperidol intramuscular administration. This study compared the effectiveness of these injections in reducing the need for restraint during agitated-psychotic episodes that include aggression. Sociodemographical and clinical data were retrieved from the electronic medical records of 179 patients who needed rapid calming while hospitalized in a mental health center with acute psychosis. The treatments administered were olanzapine intramuscular, zuclopenthixol acetate intramuscular, and haloperidol intramuscular. The assessed outcomes were rate of restraint and violent behavior. Olanzapine was found significantly more effective in reducing the need for restraint compared to zuclopenthixol acetate. No significant differences were found between haloperidol and the other two with regard to restraint. Neither were other significant differences found between the groups with regard to violent or self-harming behaviors. No significant differences were found in the rate of violent behavior and antipsychotic dosage at discharge. In conclusion, in inpatients with acute agitated psychosis, olanzapine intramuscular shows better efficacy in reducing the need for restraint, at least as compared to zuclopenthixol acetate intramuscular.

Topics: Antipsychotic Agents; Benzodiazepines; Clopenthixol; Haloperidol; Humans; Injections, Intramuscular; Olanzapine; Psychomotor Agitation; Psychotic Disorders

Topics: Aggression; Antineoplastic Agents, Hormonal; Antipsychotic Agents; Clopenthixol; Humans; Huntington Disease; Injections, Intramuscular; Male; Medroxyprogesterone Acetate; Psychomotor Agitation

Topics: Aged; Antipsychotic Agents; Clopenthixol; Dementia; Depressive Disorder; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Psychomotor Agitation; Psychotic Disorders