For people with schizophrenia, agitation is a serious problem. Agitation may proceed to aggression, putting patients and everyone around them at risk. Agitated individuals also do not respond well to normal therapeutic interventions. Recently, an inhaled version of the typical antipsychotic drug Loxitane (loxapine) was tested as a possible first-line treatment for cases of agitation in people with schizophrenia. The oral form of this medication has been in use for many years, with well-established benefits and side effects.
Among the advantages to inhaled medications is a faster onset of effects. However, along with this faster onset comes the potential for more serious adverse events and previously unseen side effects related to inhalation of the medication. A placebo-controlled study at 24 psychiatric research centers provided some definitive data on the usefulness of inhaled Loxitane.
The study included nearly 350 individuals, ranging in age from 18 to 65. When signs of agitation occurred, the individual was given between one and three doses of either Loxitane or placebo within a 24-hour period. If symptoms did not improve, a dose of the tranquilizer Ativan (lorazepam) was administered. Study authors found that inhaled Loxitane performed very well against placebo. On a standard agitation rating scale, patients showed significant improvement for a full 24 hours after a single dose. Perhaps more importantly, the positive effects of the drug began in as little as 10 minutes, a meaningful advantage over oral formulations.
Side effects of inhaled Loxitane were not shown to be more troublesome than those of the traditional oral tablet. There were no side effects that could be correlated to the inhaled nature of the medication. The most common complaint was drowsiness, followed by dizziness and taste distortions. Only three instances of severe side effects occurred in the experimental group. Interestingly, three cases of severe side effects also occurred in the placebo group. The overall impression is that inhaled Loxitane is at least as safe as both the oral form and the comparable medications in its class. Researchers are interested in determining whether this medication might be helpful in treating other cases of agitation. For example, children and adults with autism may benefit from a fast-acting medication that can be self-administered. The low incidence of side effects is equally encouraging.
Lesem, M.D., Tran-Johnson, T.K., Riesenberg, R.A., et al. (2011). Rapid acute treatment of agitation in individuals with schizophrenia: Multicentre, randomized, placebo-controlled study of inhaled loxapine. British Journal of Psychology, 198, 51-58.
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