Abstract
Acute agitation can be a clinical manifestation and complication of schizophrenia or bipolar disorder, posing a risk for a patient, others, and medical staff. Treatment of choice are antipsychotics, preferrably oral formulation.
In addition to tablet and solution form, inhalation administration can be now used. Loxapine inhalation powder (Adasuve(R)) has been recently approved for treatment of acute agitation in patients with schizophrenia and bipolar disorder.
In randomized, double-blind, placebo-controlled trials, inhaled loxapine 5 or 10 mg significantly reduced agitation, with the onset of effect seen within 10 minutes after administration. Inhaled loxapine was generally well tolerated.
The most frequent adverse events were dysgeusia and sedation. Loxapine inhalation powder is contraindicated in patients with airways disease associated with bronchospasm or acute respiratory symptoms.
Inhaled loxapine provides a novel option for treatment of acute agitation in patients with schizophrenia and bipolar disorder combining a rapid onset of effect with a noninvasive route of administration.