SynthesisThe Cochrane database of systematic reviews2007
'As required' medication regimens for seriously mentally ill people in hospital.
Synthesis in The Cochrane database of systematic reviews, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Droperidol for psychosis-induced aggression or agitation.The Cochrane database of systematic reviews · 2016Pooled it
- Haloperidol for long-term aggression in psychosis.The Cochrane database of systematic reviews · 2016Pooled it
- Haloperidol plus promethazine for psychosis-induced aggression.The Cochrane database of systematic reviews · 2016Pooled it
- 'As required' medication regimens for seriously mentally ill people in hospital.The Cochrane database of systematic reviews · 2015Pooled it
- Patient Safety andPharmacy (Basel, Switzerland) · 2018Review
- Interventions following a high violence risk assessment score: a naturalistic study on a Finnish psychiatric admission ward.BMC health services research · 2017Article
- Reducing the rates of prescribing high-dose antipsychotics and polypharmacy on psychiatric inpatient and intensive care units: results of a 6-year quality improvement programme.Therapeutic advances in psychopharmacology · 2015Article
- Pro re nata (as needed) psychotropic medication use in patients with borderline personality disorder and subjects with other personality disorders over 14 years of prospective follow-up.Journal of clinical psychopharmacology · 2014Article
- Effects of a recovery-oriented cognitive therapy training program on inpatient staff attitudes and incidents of seclusion and restraint.Community mental health journal · 2014Article
- A prospective study of high dose sedation for rapid tranquilisation of acute behavioural disturbance in an acute mental health unit.BMC psychiatry · 2013Article
- Psychotropic drug prescribing in a Nigerian psychiatric hospital.International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists · 2009Article
Corrections and comments
- Updated by
- Update of
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrugs used to treat psychotic illnesses may take weeks to be effective. In the interim, additional 'as required' doses of medication can be used to calm patients in psychiatric wards. The practice is widespread with 20% - 50% of people on acute psychiatric wards receiving at least one 'as required' dose of psychotropic medication during their admission.
objectivesTo compare the effects of 'as required' medication regimens with regular regimens of medication for the treatment of psychotic symptoms or behavioural disturbance, thought to be secondary to psychotic illness. SEARCH STRATEGY: For this 2006 update, we searched The Cochrane Schizophrenia Group's register of trials (March 2006). SELECTION CRITERIA: We included all relevant randomised control trials involving hospital inpatients with schizophrenia or schizophrenia-like illnesses, comparing any regimen of medication administered for the short term relief of behavioural disturbance, or psychotic symptoms, to be given at the discretion of ward staff ('as required', 'prn') with fixed non-discretionary patterns of drug administration of the same drug(s). This was in addition to regular psychotropic medication for the long-term treatment of schizophrenia or schizophrenia-like illnesses where prescribed. DATA COLLECTION AND ANALYSIS: We independently inspected abstracts, extracted data from the papers and quality assessed the data. For dichotomous data we would have calculated the relative risks (RR), with the 95% confidence intervals (CI) and the number needed to treat statistic (NNT). Analyses would have been conducted on an intention-to-treat basis. MAIN
resultsWe didn't identify any randomised trials comparing 'as required' medication regimens to regular regimens of the same drug. AUTHORS'
conclusionsThere is no evidence from within randomised trials to support this common current practices. Current practice is based on clinical experience and habit rather than high quality evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.