Brief Psychotic Disorder Treatment & Management

  • Author: Mohammed A Memon, MD; Chief Editor: David Bienenfeld, MD   more...
 
Updated: Jan 17, 2012
 

Medical Care

  • Patients with acute psychotic attack may need a brief hospitalization for evaluation and safety concerns. If a patient becomes aggressive and combative, brief seclusion or restraint may be necessary to ensure safety of the patient and/or others.
  • Because of the short duration of brief psychotic disorder, the treatment is brief and focused on being least restrictive. However, since it is rapid in onset and quick in course, it remains clinically imperative to protect the patient from self-injury or harm to others. Hence, a brief hospitalization may be in order.
  • If symptoms are only minimally impairing the patient's function and a specific stressor is identified, removing the stressor should suffice.
  • In the event that symptoms are disabling, an antipsychotic agent should be used for no longer than a month. If adverse effects are intolerable, the use of atypical antipsychotics may be helpful. Unfortunately, not enough information is available in the literature to support the use of atypical antipsychotics for the treatment of brief psychotic disorder. A case series suggests that rapid tranquilization with olanzapine can achieve symptom relief in acute psychosis.[7] A study involving intramuscular ziprasidone showed greater efficacy and tolerability than intramuscular haloperidol in treating acute psychosis.[8] In the authors' experience, intramuscular ziprasidone is the most effective treatment of acute severe psychotic agitation .
  • After the acute episode is resolved, individual, family, and group therapy may be considered to help cope with stressors, resolve conflict, and improve self-esteem and self-confidence.
Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Mohammed A Memon, MD  Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Coauthor(s)

Michael F Larson, DO  Clinical Instructor, Department of Child and Adolescent Psychiatry, Harvard Medical School; Psychiatrist, Harvard Vanguard Medical Associates and Private Practice

Michael F Larson, DO is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Child and Adolescent Psychiatry, and American Society of Addiction Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Alan D Schmetzer, MD  Professor Emeritus, Interim Chairman, Vice-Chair for Education, Associate Residency Training Director in General Psychiatry, Fellowship Training Director in Addiction Psychiatry, Department of Psychiatry, Indiana University School of Medicine; Addiction Psychiatrist, Midtown Mental Health Cener at Wishard Health Services

Alan D Schmetzer, MD is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Clinical Psychiatrists, American Academy of Psychiatry and the Law, American College of Physician Executives, American Medical Association, American Neuropsychiatric Association, American Psychiatric Association, and Association for Convulsive Therapy

Disclosure: Eli Lilly & Co. Grant/research funds Other

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD  Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

David Bienenfeld, MD  Professor of Psychiatry, Vice-Chair and Director of Residency Training, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Nothing to disclose.

References

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  2. Susser E, Wanderling J. Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Arch Gen Psychiatry. Apr 1994;51(4):294-301. [Medline].

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  8. Brook S, Lucey JV, Gunn KP. Intramuscular ziprasidone compared with intramuscular haloperidol in the treatment of acute psychosis. Ziprasidone I.M. Study Group. J Clin Psychiatry. Dec 2000;61(12):933-41. [Medline].

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