Agitation is a common and costly phenomenon associated with a number of psychiatric conditions including schizophrenia and bipolar disorder. Early identification and prompt intervention to relieve the symptoms of agitation are essential to avoid symptomatic escalation and emergence of aggressive behaviour. Recent consensus guidelines emphasise the need for non-coercive management strategies to protect the therapeutic alliance between patients and their healthcare providers-an alliance that is critical for the effective management of chronic psychiatric conditions. Rapid symptom relief and de-escalation of agitation are necessary to avoid the costly and traumatic use of coercive techniques of physical restraint and seclusion, which require admission and prolonged hospitalisation. Inhaled loxapine is approved for the treatment of acute agitation in patients with schizophrenia or bipolar disorder. Clinical studies have confirmed the efficacy, rapid onset of action, and safety and tolerability of this agent in the psychiatric emergency and hospital settings. Emerging data have indicated the potential for inhaled loxapine as a self-administered agent for use in the community setting without the direct supervision of a healthcare professional. We discuss the evolving treatment paradigm and the place of inhaled medications for acutely agitated patients both within and outside the emergency and hospital setting.

中文翻译：

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吸入洛沙平治疗躁郁症和精神分裂症的急性躁动：变革时代的专家点评和评论。

躁动是一种常见且代价高昂的现象，与包括精神分裂症和躁郁症在内的许多精神疾病有关。早期识别和及时干预以减轻躁动症状对于避免症状升级和出现攻击性行为至关重要。最近的共识性指南强调需要采取非强制性管理策略来保护患者及其医疗保健提供者之间的治疗联盟，这一联盟对于有效管理慢性精神病至关重要。为避免昂贵的创伤性物理约束和隔离技术的使用（需要入院和长期住院），必须快速缓解症状并减轻躁动，这是必要的。吸入洛沙平被批准用于治疗精神分裂症或躁郁症患者的急性躁动。临床研究已经证实了该药物在精神病紧急情况和医院环境中的功效，迅速起效以及安全性和耐受性。新兴数据表明，在没有医疗保健专业人员直接监督的情况下，吸入洛沙平作为自行施用的制剂有可能在社区中使用。我们讨论了急诊和医院内外急躁患者的不断发展的治疗范例和吸入药物的位置。新兴数据表明，在没有医疗保健专业人员直接监督的情况下，吸入洛沙平作为自行施用的制剂有可能在社区中使用。我们讨论了急诊和医院内外急躁患者的不断发展的治疗范例和吸入药物的位置。新兴数据表明，在没有医疗保健专业人员直接监督的情况下，吸入洛沙平作为自行施用的制剂有可能在社区中使用。我们讨论了急诊和医院内外急躁患者的不断发展的治疗范例和吸入药物的位置。