Inhaled Loxapine for Agitation in Intoxicated Patients

Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms...

Descripción completa

Detalles Bibliográficos
Autores: Roncero, Carlos|||0000-0003-1421-7385, Ros-Cucurull, Elena, Palma-Álvarez, Raúl Felipe|||0000-0002-6428-9865, Abad, Alfonso Carlos|||0000-0001-5706-7693, Fadeuilhe, Christian|||0000-0001-5821-347X, Casas Brugué, Miquel|||0000-0003-3496-8522, Grau-López, Lara|||0000-0003-1297-1819
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:186355
Acceso en línea:https://ddd.uab.cat/record/186355
https://dx.doi.org/urn:doi:10.1097/WNF.0000000000000252
Access Level:acceso abierto
Palabra clave:Agitation
Inhaled loxapine
Emergency
Substance use disorders
Mental disorders
Descripción
Sumario:Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms of agitation in adults with psychiatric disorders (eg, schizophrenia) within 10 minutes of administration. Recently, some reports have documented the usefulness of loxapine in dual diagnoses patients with agitation. However, the efficacy of loxapine in intoxicated patients has not been deeply addressed. This report describes a case series of 12 patients (with addiction or dual disorder) who received inhaled loxapine for symptoms of psychomotor agitation during intoxication with different substances (eg, alcohol, cannabis, or cocaine) at 1 center in Spain. Data from 12 patients were reviewed, 5 patients were attended at the emergency room, 4 at the addiction and dual diagnosis unit, and 3 were treated during hospitalization for detoxification. All patients were under effects of substances. They had substance use disorder (including cannabis, cocaine, alcohol, hypnotics, and hallucinogens), and almost all (90%) presented 1 or more psychiatric disorders. One dose of inhaled loxapine was effective in 9 patients (75%), and in 3 patients, a second dose was required. Only mild dizziness was reported in 1 patient after the second dose. The acute agitation was effectively and quickly managed with inhaled loxapine in all intoxicated patients and enabled the appropriate clinical evaluation of the agitated state and the patient's management.