The pharmacological management of acute behavioural disturbance: Data from a clinical audit conducted in UK mental health services

Background:A quality improvement programme addressing prescribing practice for acutely disturbed behaviour was initiated by the Prescribing Observatory for Mental Health.Method:This study analysed data from a baseline clinical audit conducted in inpatient mental health services in member trusts.Results:Fifty-eight mental health services submitted data on 2172 episodes of acutely disturbed behaviour. A benzodiazepine alone was administered in 60% of the 1091 episodes where oral medication only was used and in 39% of the 1081 episodes where parenteral medication (rapid tranquillisation) was used. Haloperidol was combined with lorazepam in 22% of rapid tranquillisation episodes and with promethazine in 3%. Physical violence towards others was strongly associated with receiving rapid tranquillisation in men (odds ratio 1.74, 1.25–2.44; p<0.001) as was actual or attempted self-harm in women (odds ratio 1.87, 1.19–2.94; p=0.007). Where physical violence towards others was exhibited, a benzodiazepine and antipsy...