Clinical Psychopharmacology and Neuroscience Papers in Press available online.

 
Inhaled loxapine as a rapid treatment for agitation in patients with personality disorder: a prospective study on the effects of time
Marc Ferrer 1,2,3, Óscar Soto-Angona 1,*, María Soler-Artigas 2,3,5, Pol Ibáñez3, Christian Fadeuilhe 1,2,3, Raúl Felipe Palma-Álvarez 1,2,3, Raquefet Lidai1, Sebastian Vargas-Cáceres 1, María Ángeles Torrecilla1, Anna López1, Josep Antoni Ramos-Quiroga 1,2,3
1Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Catalonia, Spain, 2Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain, 3Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain, 4Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain, 5Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
Abstract
Objective
Agitation in patients diagnosed with Personality Disorders (PD) is one of the most frequent crises in emergency departments (ED). Although many medications have been tested, their effectiveness has been small or non-significant, and no specific drugs are supported by the available evidence. This study aimed to evaluate the efficacy of Inhaled loxapine (IL) as a therapeutic option for agitated patients with PD.
Methods
A naturalistic, unicentric, prospective study was carried out. Thirty subjects diagnosed with PD and attending the ED with episodes of agitation were recruited most of whom were women diagnosed with Borderline Personality Disorder. Subjects were treated with a single dose of IL (9.1mg). Efficacy was assessed with the Clinical Global Impression (CGI) scale, the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Patients were followed 60 minutes after administration to measure IL effect and its duration.
Results
IL exhibited an overall efficacy in managing mild to severe agitation, with a quick onset of effect and persistence. ‘Effect of time’, where IL efficacy is maintained over time, is more marked in higher-severity agitation. No additional treatments were needed to improve agitation during the follow-up time.
Conclusions
Results suggest that IL could be a safe and effective option to manage agitation in PD.
Accepted Manuscript [Submitted on 2021-02-09, Accepted on 2021-06-01]