Abstract

Background: Emergencies in psychiatry have a peculiar pattern of presentation, with florid aggression and agitation being very common. Such presentations may pose threats to the patients themselves, those around them, and the environment. The primary goal of intervention is to ensure the safety of the patient, personnel, and surroundings.

Aim: This study aimed to determine the effectiveness of oral medications—chlorpromazine, olanzapine, and diazepam—in calming patients during episodes of aggression.

Methods: This was a pragmatic randomized experimental study conducted at the emergency psychiatry department of the Federal Neuropsychiatric Hospital, Yaba. A total of 80 participants were enrolled. Benzodiazepines (diazepam) and antipsychotics (chlorpromazine and olanzapine) were administered individually or in combination and randomly assigned. Patients who did not achieve calmness within 60 minutes of administration were given parenteral medications. Sociodemographic and clinical questionnaires were used, alongside the Modified Overt Aggression Scale. Data analysis was conducted using SPSS version 26.

Results: Over half of the participants (55%) responded well to oral tranquilization without requiring parenteral medications. Poor response to oral tranquilization, necessitating parenteral administration, was more common among participants aged 18–40 years (OR = 20.744, 95% CI = 3.608–11.268, p = 0.001), males (OR = 6.607, 95% CI = 1.664–26.235, p = 0.007), and those with substance use disorders (OR = 0.069, 95% CI = 0.009–0.506, p = 0.009).

Conclusion: Oral tranquilization was more successful among older patients, females, and those diagnosed with bipolar disorder or schizophrenia.

Key words: : aggression, effectiveness, oral tranquilization, psychiatric emergency