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Establishing gold standard approaches to rapid tranquillisation: a review and discussion of the evidence on the safety and efficacy of medications currently used

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Pratt, J. Peter, Chandler-Oatts, Jacqueline, Nelstrop, Louise, Branford, David, Pereira, Stephen M. and Johnston, Susan. (2008) Establishing gold standard approaches to rapid tranquillisation: a review and discussion of the evidence on the safety and efficacy of medications currently used. Journal of Psychiatric Intensive Care, Vol.4 (No.1-2). pp. 43-57. ISSN 1742-6464

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Official URL: http://dx.doi.org/10.1017/S1742646408001234

Abstract

Background: Rapid tranquillisation is used when control of agitation, aggression or excitement is required. Throughout the UK there is no consensus over the choice of drugs to be used as first line treatment. The NICE guideline on the management of violent behaviour involving psychiatric inpatients conducted a systematic examination of the literature relating to the effectiveness and safety of rapid tranquillisation (NICE, 2005). This paper presents the key findings from that review and key guideline recommendations generated, and discusses the implications for practice of more recent research and information.

Aims: To examine the evidence on the efficacy and safety of medications used for rapid tranquillisation in inpatient psychiatric settings.

Method: Systematic review of current guidelines and phase III randomised, controlled trials of medication used for rapid tranquillisation. Formal consensus methods were used to generate clinically relevant recommendations to support safe and effective prescribing of rapid tranquillisation in the development of a NICE guideline.

Findings: There is a lack of high quality clinical trial evidence in the UK and therefore a ‘gold standard’ medication regime for rapid tranquillisation has not been established.

Rapid tranquillisation and clinical practice: The NICE guideline produced 35 recommendations on rapid tranquillisation practice for the UK, with the primary aim of calming the service user to enable the use of psychosocial techniques.

Conclusions and implications for clinical practice: Further UK specific research is urgently needed that provides the clinician with a hierarchy of options for the clinical practice of rapid tranquillisation.

Item Type:

Journal Article

Subjects:

R Medicine > R Medicine (General)
B Philosophy. Psychology. Religion > BF Psychology

Divisions:

Faculty of Social Sciences > School of Health and Social Studies

Library of Congress Subject Headings (LCSH):

Benzodiazepines, Antipsychotic drugs, Aggressiveness, Violence in psychiatric hospitals, Medicine and psychology, Mental illness -- Treatment, Psychiatry

Journal or Publication Title:

Journal of Psychiatric Intensive Care

Publisher:

Cambridge University Press

ISSN:

1742-6464

Official Date:

December 2008

Dates:

Date	Event
December 2008	Published

Volume:

Vol.4

Number:

No.1-2

Page Range:

pp. 43-57

Identification Number:

10.1017/S1742646408001234

Status:

Not Peer Reviewed

Access rights to Published version:

Open Access

Funder:

National Institute for Health and Clinical Excellence (Great Britain) (NICE)

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