Intramuscular olanzapine for agitated patients: A systematic review and meta-analysis of randomized controlled trials

Kishi, Taro; Matsunaga, Satoru; Iwata, Nakao

doi:10.1016/j.jpsychires.2015.07.005

Cited by 51 publications

(51 citation statements)

References 28 publications

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“…Because of the strength of evidence for efficacy in alleviating agitation in this population, aripiprazole IM (level 2),125, 126 lorazepam IM (level 2),125, 127 loxapine inhaled (Level 1)128, 129 and olanzapine IM (level 2)127, 130, 131, 132, 133 are recommended as the first‐line option. Sublingual asenapine (level 3),134 haloperidol IM (level 3),131, 135, 136 haloperidol IM + midazolam IM (level 3),131, 137 haloperidol IM + promethazine IM (level 3),131, 137, 138 risperidone ODT (level 3),136 and ziprasidone IM (level 3)131, 137, 139 are recommended as a second‐line treatment.…”

Section: Acute Management Of Bipolar Maniamentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Acute Management Of Bipolar Maniamentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…[15][16][17][18][19][20][21][22] All SRs exclusively included RCTs (nine to 32 trials per review) and pooled data for at least one outcome of interest. [18][19][20]22 The publication year of the included studies within the SRs ranged from 1969 to 2015. The total number of patients enrolled in the eligible studies ranged from 552 to 3877.…”

Section: Methodsmentioning

confidence: 99%

“…19 The individual trials that the reviews included originated from numerous jurisdictions worldwide.…”

Section: Country Of Originmentioning

confidence: 99%

“…22 Although the authors sought trials of any benzodiazepine administered at any dose or via any route, they reported the majority of trials (against the two relevant comparators) tested IM routes of benzodiazepines, mostly lorazepam. The other reviews focused on antipsychotic drugs, including IM zuclopenthixol acetate, 18 IM olanzapine, 19 and any administration of haloperidol. 20 Relevant comparators of interest in these reviews varied, and included oral and IM antipsychotic drugs and IM benzodiazepines alone, as well as a combination of haloperidol and promethazine.…”

Section: Interventions and Comparatorsmentioning

confidence: 99%

“…18 Lastly, Kishi et al tested the efficacy and safety of IM olanzapine versus placebo, IM haloperidol, IM ziprasidone, a combination of IM haloperidol and promethazine, and IM lorazepam. 19 The doses of the therapies in the above reviews varied.…”

Section: Interventions and Comparatorsmentioning

confidence: 99%

See 2 more Smart Citations

Agitation: Where We’re Going, Where We’ve Been

Zeller¹

2017

The Diagnosis and Management of Agitation

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Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic review s. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts w ithin the time allow ed. Rapid responses should be considered along w ith other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for w hich little information can be found, but w hich may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that ef fect. CADTH is not liable for any loss or damages resulting from use of the information in the report.Copyright: This report contains CADTH copyright material and may contain material in w hich a third party ow ns copyright. This report m ay be used for the purposes of rese arch or private study only. It may not be copied, posted on a w eb site, redistributed by email or stored on an electronic system w ithout the prior w ritten permission of CADTH or applicable copyrigh t ow ner.Links: This report may contain links to other information available on the w ebsites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of thi rd party sites is governed by the owners" own terms and conditions .

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Olanzapine versus placebo for people with schizophrenia

et al. 2019

Cochrane Database of Systematic Reviews

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Intramuscular olanzapine for agitated patients: A systematic review and meta-analysis of randomized controlled trials

Cited by 51 publications

References 28 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Agitation: Where We’re Going, Where We’ve Been

Olanzapine versus placebo for people with schizophrenia

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