精神科救急医療 ガイドライン（2） - jaep.jp

1 2 Guidelines for Psychiatric Emergency Treatment(2) (Pharmacological Treatment) Version 2009 1990 2003 QT 2009

2 2007 2007 7 2008 15 2009 25 4 21 12 9 I 1 1.

3 1 2. 1 3. 3 4. 5 5. 7 6. 10 7. 10 II 16 1. 16 2. 17 III 22 1. 22 2. 24 3. 25 4. 26 5. 27 -1- I. 1. 1) 2.

4 1 1) 2) 3) -2- 1. 2009 CT NoYe sYe sN o 2005 Marder 2006 2

5 2009 -3- 2 CT CPK 3.

6 1) haloperidol risperidone olanzapine -4- 2) lorazepam Modified Overt Aggression Scale (OAS) Brief Psychiatric Rating Scale (BPRS) Hostility-suspiciousness factor 72 risperidone, olanzapine, quetiapine, haloperidol haloperidol (Villari et al.

7 2008) Olanzapine haloperidol 3 20mg Positive and Negative Syndrome Scale (PANSS) Agitation subscale 1 (Kinon et al. 2004) Lorazepam risperidone haloperidol BPRS PANSS 30 90 (Veser et al. 2006) 172 haloperidol risperidone olanzapine BPRS 40% haloperidol (Crespo-Facorro B et al. 2006) haloperidol olanzapine risperidone PANSS Excitement Component (PANSS-EC) 1 olanzapine (Hatta et al.

8 2008a) quetiapine chlorpromazine olanzapine risperidone 2008 risperidone 1625 PANSS agitation subscale 15 256 (Pajonk FG et al. 2005) 88 risperidone 7 14 4 68% PANSS 50% (Yoshimura et al. 2005) Quetiapine 100mg 150mg 200mg 50% 120 40% PANSS-EC (Currier et al. 2006) 40% 25% 2 400mg -5- (Smith et al.

9 2005) Aripiprazol PANSS-EC 2 6 (Marder et al. 2007) olanzapine risperidone benzodiazepine haloperidol benzodiazepine Quetiapine perphenazine Chlorpromazine (Allen et al. 2005) 2008 12 170 31% 78% risperidone 1 Olanzapine 8% levomepromazine 6% olanzapine 52% levomepromazine 14% risperidone 12% haloperidol 11% quetiapine 9% zotepine 7% lorazepam 6% 2007 (Hatta et al.

10 2008) risperidone olanzapine 1 9 9 1 6 risperidone olanzapine 1 4. 1) haloperidol promethazine 2) haloperidol biperiden haloperidol benzodiazepine 37 2mg lorazeam 5mg haloperidol 30 4 BPRS Clinical Global Impressions (CGI) -6- (Foster et al.