When Behavioral De-escalation Isn’t Enough: Medication Management of Acute Agitation in Manic and Psychotic Patients-View Presentation

Video Transcription

Video Summary

The video is a comprehensive presentation on managing acute agitation in psychosis and mania, focusing on psychopharmacology. Dr. Osser, alongside Dr. Sean Stetson, discusses the treatment options and guidelines derived from their research and paper published a year prior. They present their methodology for constructing these guidelines, emphasizing an evidence-based approach, although they acknowledge the limitations due to the scarcity of high-quality studies. The presentation reviews various medications and their effectiveness, administration routes (oral, sublingual, IM), and discusses the pros and cons of each option. They also address the challenges of combining different studies due to their heterogeneous nature—ranging from different patient conditions to diverse international treatment settings.<br /><br />Special attention is paid to the preferred treatment tiers for oral and IM medications based on their assessment. The team categorizes medications into first, second, and third tiers for oral and IM administration, with medications like haloperidol, olanzapine, and lorazepam being significant mentions. They delve into newer medications like dexmedetomidine and assess its efficacy and concerns compared to traditional drugs.<br /><br />The presentation encourages non-medication interventions wherever possible and highlights the associated risks of medical interventions. Moreover, Dr. Osser emphasizes the availability of their algorithms for practitioners' reference through a website they manage, offering a practical tool for applying these guidelines. The session is interactive, with numerous audience questions, indicating a dynamic learning environment.

Keywords

acute agitation

psychosis management

mania treatment

psychopharmacology

treatment guidelines

medication effectiveness

oral administration

IM administration

haloperidol

olanzapine

lorazepam

dexmedetomidine