Clinical Outcomes in Patients Taking Inhaled Loxapine, Haloperidol, or Ziprasidone in the Emergency Department

Marc McDowell, Kara Nitti, Erik Kulstad, Michael Cirone, Riddhi Shah, Daniel Rochford, Richard Walsh, Kathleen Hesse

Research output: Contribution to journalArticle

Abstract

Objectives Our objective was to compare outcomes of discharge disposition, need for additional medications, and restraint use for patients who received inhaled loxapine compared with patients receiving traditional antipsychotic drugs in the emergency department (ED). Methods A retrospective chart review was conducted on all patients who presented to the ED with agitation and received antipsychotic therapy, including loxapine, ziprasidone, or haloperidol from December 1, 2014, through October 31, 2016. Results The mean time from physician assignment to medical clearance was 7.9 hours for patients treated with inhaled loxapine versus 10.3 hours for controls (P < 0.01). Those who received inhaled loxapine were given significantly less benzodiazepines as additional rescue medications as compared with other antipsychotic medications (P < 0.01, 35.2% vs 65.1%). Additionally, restraints were utilized less frequently in the loxapine group (P < 0.01, 1.8% vs 19.8%). Conclusions Treating patients with agitation due to psychotic episodes in an ED setting with inhaled loxapine versus haloperidol or ziprasidone was associated with significantly improved treatment outcomes, suggesting that inhaled loxapine may be a more effective and rapid treatment option.

Original languageEnglish (US)
Pages (from-to)23-26
Number of pages4
JournalClinical Neuropharmacology
Volume42
Issue number2
DOIs
StatePublished - Mar 1 2019

Fingerprint

Loxapine
Haloperidol
Hospital Emergency Service
Antipsychotic Agents
ziprasidone
Benzodiazepines
Physicians

Keywords

  • agitation
  • antipsychotic medication
  • mental disorders
  • restraint utilization

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Clinical Outcomes in Patients Taking Inhaled Loxapine, Haloperidol, or Ziprasidone in the Emergency Department. / McDowell, Marc; Nitti, Kara; Kulstad, Erik; Cirone, Michael; Shah, Riddhi; Rochford, Daniel; Walsh, Richard; Hesse, Kathleen.

In: Clinical Neuropharmacology, Vol. 42, No. 2, 01.03.2019, p. 23-26.

Research output: Contribution to journalArticle

McDowell, Marc ; Nitti, Kara ; Kulstad, Erik ; Cirone, Michael ; Shah, Riddhi ; Rochford, Daniel ; Walsh, Richard ; Hesse, Kathleen. / Clinical Outcomes in Patients Taking Inhaled Loxapine, Haloperidol, or Ziprasidone in the Emergency Department. In: Clinical Neuropharmacology. 2019 ; Vol. 42, No. 2. pp. 23-26.
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