ArticlesOrally Versus Intramuscularly Administered Antipsychotic Drugs in Psychiatric EmergenciesCURRIER, GLENN W., MD, MPH; MEDORI, ROSSELLA, MDAuthor Information CURRIER: University of Rochester Medical Center, Rochester, New York; MEDORI: Janssen-Cilag EMEA, Beerse, Belgium. Please send correspondence and reprint requests to: Glenn W. Currier, MD, MPH, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642. Dr Currier has been a consultant for, received honoraria from, and participated in speakers/advisory boards for Pfizer, AstraZeneca, and Janssen and has received grants/research support from Janssen and AstraZeneca. Dr Medori is an employee of Janssen-Cilag, EMEA. No funding was provided for the development of this article. Journal of Psychiatric Practice®: January 2006 - Volume 12 - Issue 1 - p 30-40 Buy SDC Abstract High utilization of emergency services by patients at increased risk for agitation and aggression makes the determination of effective therapy a major concern of psychiatric care. Agitated and aggressive behavior needs to be treated rapidly and effectively to minimize the risk to both patients and staff. Traditionally, short-acting intramuscular (IM) formulations of conventional antipsychotic drugs have been preferred in the emergency setting due to their rapid onset of action and the ability to administer them to uncooperative patients. IM injections, however, may not always be the preferred option. Recently, orally administered second generation (atypical) antipsychotics have been shown to be at least as effective in managing acute agitation as conventional antipsychotic drugs, with a superior tolerability profile. The current review evaluates pharmacokinetic parameters, formulation options, and clinical efficacy data for the treatment of acute agitation or aggressive behavior with antipsychotic medications. A synthesis of data from individual clinical trials, meta-analyses, review articles, and expert consensus recommendations is used to develop a working clinical algorithm for the acute management of aggression and agitation. Copyright © 2006 Wolters Kluwer Health, Inc. All rights reserved.