|Beitragstitel||Promethazine and diazepam in agitation in bipolar disorder with cocaine dependence.|
Agitation is a syndrome rather than a disorder for itself characterized by excessive motor activity associated with a feeling of inner tension which is expressed on a wide spectrum of behaviors . The best treatment intervention could give high benefit and low risk like high response without oversedation or other problematic adverse events, as well as considering patient acceptability . The aim of this study is to evalued the efficacy and tollerability of the association of promethazine and diazepam in a sample of bipolar patients (BD) with cocaine intoxication (CI).
Twentyfive BD inpatients presenting with CI were assessed with SCID-P for Axis I diagnosis, Brief Psychiatric Rating Scale (BPRS) for the general psychopatology, Hamilton Rating Scale for Depression (HRSD) to quantify depressive features, Young Mania Rating Scale (YMRS) to measure manic symptoms, UKU scale to determine the tollerability of the treatment, CGI for the severity of the illness as well as general medicine review (ECG). We conducted a systematic literature review with the principal scientific databases (PubMed, Embase, PsychInfo) using the key terms “Agitation”, “Prometazine” and “Diazepam”.
All the patients were diagnosed with BD, and have concomitant CI that presented with agitation and psychomotor activation in the context of a mixed state. They also reported high scores at the BPRS in the items 6 (Mean= 5), 4 (Mean=4), 10 (mean=4), 11 (mean=4) and 17 (Mean=5). There aren’t signigìficant different in the sociodemographic characteristics as well as in neurological and general medicine review. The principal side effect at the UKU scale are sedation, and somnolence. The treatment response is in 30-60 minutes. There aren’t significant cardiovascular alterations evaluated at ECG.
Discussion and conclusion
In literature there are no studies that evaluated the efficacy and tollerability of intramuscolar association of promethazine and diazepam in a sample of BD inpatients wit Acute CI. Our findings suggest that this association is safety without particular side effects (only sedation and somnolence) and severe adverse events, and it’s possibile useful treatment strategy in BD inpatients with acute CI. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed.
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