3.3.4.1 Atypical Antipsychotics

Comment on the use of atypical antipsychotic medications in the treatment of agitated and aggressive behaviour?

  1. Atypical antipsychotic medications include Risperidone, Seroquel and Olanzepine.
     
  2. Generally used early on because of their relatively rapid action.
     
  3. Always concern about the use of neuroleptic medications, particularly given it potential impact on neurological recovery.
  • Atypical antipsychotic drugs such as olanzapine and risperidoneare increasingly being used as first line treatment for individuals with psychotic disorders and increasingly being used for decreasing agitation and aggression. 
     
  • Studies were conducted which reported that these drugs can be effective for some patients with traumatic brain injury 25.
     
  • Study recommendations include:
  • One studying suggesting beginning with a dose of olanzapine 2.5-5 mg QHS or BID and then increase in increments of 2.5-5 mg up to 20 mg/day and;
     
  • Risperidone would start with 0.5 mg QHS or BID and increase in increments of 0.5-1mg up to 4-6 mg/day 26although many clinicians will stop at 3 gm/day.