Psychotropics in Emergency Therapy in Hungary: a Comparison with International Trends

Introduction In several countries including Hungary no emergency care guidelines are available, and studies regarding everyday clinical emergency practice are also lacking. Objectives The aims of the present study was to assess practice related to emergency care of agitated-psychotic patients in emergency settings in Hungary as well as to compare it with internationals trends. Methods Anonymous survey questionnaires were dispatched to 210 institutions providing psychiatric care in Hungary in 2013 consisting of questions related to care of an agitated patient showing psychotic symptoms. The results were compared with data from the latest international studies carried out in this field. Results 155 completed questionnaires were returned. Of the participating clinicians 18.7% would apply monotherapy, 76.1% dual combination, 5.2% a triple combination of medications. 92.9% of participants indicated haloperidol among first-line medications. 80.6% of participants would take a combination with benzodiazepines. 59.4% would use IV and 23.9% IM therapy, and 9% would apply the combination of these two. 7.7% of participants did not answer this question. Conclusions Our results indicate that administration of haloperidol and benzodiazepines is a widespread practice in the emergency care of agitated psychotic patients in Hungary which corresponds to dominant trends in international practice as reflected by the latest international survey. The international survey including 21 countries indicate that three countries (India, Romania, Slovenia) regularly use IV medications, whereas others do not do this at all, and only use IM medication. Hungarian clinicians disagree on mode of administration, but the majority would prefer IV therapy.