Inhaled loxapine: a new treatment for agitation in schizophrenia or bipolar disorder

The treatment of acute agitation in psychiatric patients has traditionally involved the use of oral or intramuscular benzodiazepines, antipsychotics or their combination. However, oral medication may have too slow an onset and while the intramuscular route is faster, it carries an increased risk of adverse events and needle-stick injury. A new delivery modality has been devised using an inhalation-activated, thermally generated drug aerosol which can produce peak plasma concentrations in a few minutes. Using this delivery method, loxapine was assessed for its antiagitation effects in schizophrenia and bipolar I disorder patients. It produced a rapid calming effect without undue sedation. It was generally well tolerated, with dysgeusia being the most common adverse event.