0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter   |    
Managing Aggressive Psychotic Patients
Francis J. Durgin, M.D.
Psychiatric Services 2000; doi: 10.1176/appi.ps.51.3.391
text A A A

To the Editor: I enjoyed Dr. Hughes' article on the acute psychopharmacological management of the aggressive psychotic patient in the September 1999 issue and found it quite complete. However, I have to question the emergency administration of psychotropic medications orally, for several reasons. Not only do medications that are administered intramuscularly act more quickly at full strength because they avoid liver pass, but also, and much more important, titration is immeasurably more dependable.

Variations in absorbtion of orally administered drugs range from a few minutes to several hours. Therefore, after a half hour to an hour or two, there is no way of knowing, in the absence of a response, whether the drug has not been absorbed or whether the dosage perhaps must be much increased. This situation can be both frustrating and potentially dangerous. Perhaps two or more doses will be absorbed all at once, producing a toxic response.

I routinely ask nurses to administer such medications intramuscularly, even when the patient is quite compliant, to assure not only the quickest response but also the safest and most predictable control.

Dr. Durgin is in private practice in Fayetteville, New York.

+

References

+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 50.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 61.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 61.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 62.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 62.  >
Topic Collections
Psychiatric News
PubMed Articles