Prescription Patterns of Intramuscular Medication for Psychomotor Agitation: A Survey of Italian Psychiatrists
Calogero Crapanzano1, Noemi Redaelli2, Andrea Politano3, Ilaria Casolaro4, Chiara Amendola5
1ASPAG, CSM Licata, Licata, Italy
2University of Pavia, Faculty of Medicine and Surgery, Pavia, Italy
3Clinica S. Croce, Orselina, Switzerland
4ASST Ovest Milanese, Milano, Italy
5Azienda USL Toscana Centro, CSM Scandicci, Firenze, Italy
Correspondence to: Calogero Crapanzano
ASPAG, CSM Licata, C/da Cannavecchia c/o Ospedale San Giacomo D’Altopasso, 92027 Licata, Italy
E-mail: calogerocrapanzano87@gmail.com
ORCID: https://orcid.org/0000-0001-6006-1268
Received: October 25, 2023; Revised: December 13, 2023; Accepted: December 19, 2023; Published online: January 18, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

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Abstract
Objective: Intramuscular medications are widely used to treat psychomotor agitation (PMA) in uncooperative patients. We evaluated knowledge and attitude towards guidelines and the prescribing patterns in a sample of Italian psychiatrists.
Methods: A structured 28-item questionnaire was submitted to psychiatrists of Italian Departments of Mental Health. We considered 8 clinical scenarios of PMA. For comparing two qualitative variables Chi-square tests were performed.
Results: One hundred thirty-four psychiatrists completed the survey. The use of a monotherapy is significatively higher (p < 0.05) over a dual therapy in all clinical scenarios except PMA due to Mood Disorder and Psychotic Disorders, whereas the use of a polytherapy is significatively higher (p < 0.05) in PMA due to Mood Disorders and Psychotic Disorders. The use of second-generation antipsychotic (SGAs) as monotherapy over first-generation antipsychotics (FGAs) is significantly higher (p < 0.05) in PMA due to Central Nervous System (CNS) stimulants. The use of SGAs over FGAs in polytherapy is significantly higher (p < 0.05) in PMA due to CNS stimulants. Knowledge of guidelines results 67.1% and significatively higher (p < 0.05) among those who prefer SGAs as monotherapy rather than FGAs in PMA due to Intellectual Disability, CNS depressants and Delirium. Knowledge of guidelines results significatively higher (p < 0.05) among those who prefer SGAs rather than FGAs in polytherapy in PMA due to Mood disorders.
Conclusion: This survey reports variation in prescribing patterns for medication used to treat PMA. While SGAs are often prescribed as first choice following the more recent guidelines, FGAs and multi-drug solutions seem to be still a popular solution.
Keywords: Survey; Psychomotor agitation; Antipsychotics; Benzodiazepines; Guidelines


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