When haloperidol and midazolam were compared with olanzapine , there was some evidence the combination was superior in terms of improvement , sedation and behaviour .
There were relatively little good data and most trials are too small to highlight differences in either positive or negative effects .
Adding a benzodiazepine to other drugs does not seem to confer clear advantage and has potential for adding unnecessary adverse effects .
Sole use of older antipsychotics unaccompanied by anticholinergic drugs seems difficult to justify .
BACKGROUND Acute psychotic illness , especially when associated with agitated or violent behaviour , can require urgent pharmacological tranquillisation or sedation .
In several countries , clinicians often use benzodiazepines ( either alone or in combination with antipsychotics ) for this outcome .
OBJECTIVES To estimate the effects of benzodiazepines , alone or in combination with antipsychotics , when compared with placebo or antipsychotics , alone or in combination with antihistamines , to control disturbed behaviour and reduce psychotic symptoms .
PET analysis of the 5-HT2A receptor inverse agonist ACP-103 in human brain.
The mechanisms underlying the clinical properties of atypical antipsychotics have been postulated to be mediated , in part , by interactions with the 5-HT2A receptor . Recently , it has been recognized that clinical ly effective antipsychotic drugs are 5-HT2A receptor inverse agonists rather than neutral antagonists . In the present study , which is part of the clinical development of the novel , selective 5-HT2A receptor inverse agonist ACP-103 , we applied positron emission tomography ( PET ) with the radiolig and [11C]N-methylspiperone ( [11C]NMSP ) to study the relationship between oral dose , plasma level , and uptake of ACP-103 in living human brain . The safety of drug administration was also assessed . Four healthy volunteers were examined by PET at baseline , and after the oral administration of various single doses of ACP-103 . Two subjects each received 1 , 5 , and 20 mg doses , and two subjects each received 2 , 10 , and 100 mg doses , respectively . ACP-103 was well tolerated . Detectable receptor binding was observed at very low ACP-103 serum levels . Cortical [11C]NMSP binding was found to be dose-dependent and fitted well to the law of mass action . A reduction in binding was detectable after an oral dose of ACP-103 as low as 1 mg , and reached near maximal displacement following the 10 - 20 mg dose . In conclusion , administration of ACP-103 to healthy volunteers was found to be safe and well tolerated , and single oral doses as low as 10 mg were found to fully saturate 5-HT2A receptors in human brain as determined by PET
When haloperidol and midazolam were compared with olanzapine , there was some evidence the combination was superior in terms of improvement , sedation and behaviour .
There were relatively little good data and most trials are too small to highlight differences in either positive or negative effects .
Adding a benzodiazepine to other drugs does not seem to confer clear advantage and has potential for adding unnecessary adverse effects .
Sole use of older antipsychotics unaccompanied by anticholinergic drugs seems difficult to justify .
BACKGROUND Acute psychotic illness , especially when associated with agitated or violent behaviour , can require urgent pharmacological tranquillisation or sedation .
In several countries , clinicians often use benzodiazepines ( either alone or in combination with antipsychotics ) for this outcome .
OBJECTIVES To estimate the effects of benzodiazepines , alone or in combination with antipsychotics , when compared with placebo or antipsychotics , alone or in combination with antihistamines , to control disturbed behaviour and reduce psychotic symptoms .