• Samuel Mullinax, Farhad Shokraneh, Michael P Wilson, and Clive E Adams.
• Department of Emergency Medicine Behavioral Emergences Research (DEMBER) Lab, Little Rock, Arkansas.
• J Emerg Med. 2017 Oct 1; 53 (4): 524529524-529.

BackgroundUnderstanding more about the efficacy and safety of oral second-generation antipsychotic medications in reducing the symptoms of acute agitation could improve the treatment of psychiatric emergencies.ObjectiveThe objective of this scoping review was to examine the evidence base underlying expert consensus panel recommendations for the use of oral second-generation antipsychotics to treat acute agitation in mentally ill patients.MethodsThe Cochrane Schizophrenia Group's Study-Based Register was searched for randomized controlled trials comparing oral second-generation antipsychotics, benzodiazepines, or first-generation antipsychotics with or without adjunctive benzodiazepines, irrespective of route of administration of the drug being compared. Six articles were included in the final review.ResultsTwo oral second-generation antipsychotic medications were studied across the six included trials. While the studies had relatively small sample sizes, oral second-generation antipsychotics were similarly effective to intramuscular first-generation antipsychotics in treating symptoms of acute agitation and had similar side-effect profiles.ConclusionsThis scoping review identified six randomized trials investigating the use of oral second-generation antipsychotic medications in the reduction of acute agitation among patients experiencing psychiatric emergencies. Further research will be necessary to make clinical recommendations due to the overall dearth of randomized trials, as well as the small sample sizes of the included studies.Copyright © 2017 Elsevier Inc. All rights reserved.

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