Table 1. Recommended oral medications for rapid tranquilization in psychomotor agitation* .
| Medication | Dosage (mg) | Initial effects (h) | Half-life (h) | Can repeat (h) | Maximum dosage per 24 h (mg) | Side effects | Level of evidence | Grade of recommendation |
|---|---|---|---|---|---|---|---|---|
| Risperidone (PO/OS/ODT†) | 2-3 | 1 | 24 | 1 | 8 | Drowsiness, dizziness, EPS, hemodynamic effects, seizures, dysphagia, nausea, cardiac arrhythmia, hypotension | 1B | A |
| Asenapine (SL) | 10 | 0.5-1.5 | 24 | 12 | 20 | EPS, hemodynamic effects, seizures, dysphagia | 1B | A |
| Risperidone (OS/PO) + lorazepam (PO) | 2 + 2 | 1 | 24 | 1 | 6/6 | EPS, hemodynamic effects, seizures, dysphagia, cardiac arrhythmia, hypotension, dizziness, oversedation, respiratory depression | 2A | B |
| Olanzapine (ODT/PO) | 10 | 1-2/4-6 | 21-54 | 2/4 | 30 | EPS, hemodynamic effects, seizures, dysphagia, cardiac arrhythmia, hypotension, dizziness | 2A | B |
| Haloperidol (PO/OS) | 5-15 | 1-4 | 15-37 | 8 | 15 | EPS, hemodynamic effects, seizures, dysphagia, ECG alterations | 2B | B |
| Risperidone (OS/PO) + clonazepam (PO) | 2 + 2 | 1 h | 20-40 | 1 | 6/6 | EPS, hemodynamic effects, seizures, dysphagia, cardiac arrhythmia, hypotension, dizziness, oversedation, respiratory depression | 2B | B |
| Clonazepam (PO/OS) | 2 | 1-3 | 20-40 | 1 | 8 | Amnesia, ataxia, oversedation, dizziness, paradoxical effect | 5 | D |
| Diazepam (PO) | 10 | 0.5-1.5 | 20-80 | 1 | 60 | Amnesia, ataxia, oversedation, dizziness, paradoxical effect | 5 | D |
| Lorazepam (PO) | 2-4 | 2 | 8-16 | 2 | 4 | Amnesia, ataxia, oversedation, dizziness, paradoxical effect | 5 | D |
*
Only recommended formulations are included.
†
Not available in Brazil.
ECG = electrocardiogram; EPS = extrapyramidal side effects; ODT = oral disintegrating tablets; OS = oral solution; PO = from the Latin per orem; SL = sublingual.