Comparative effectiveness and safety of pharmacological treatments for rapid tranquilisation in emergency settings: a systematic review and individual participant data network meta-analysis

作者：Spyridon Siafis, Frederik Philipona, Nobuyuki Nomura, F. Milosavljević, Konstantina Chalkou, Johannes Schneider‐Thoma, Irene Bighelli, Carolin Lorenz, Joseph E. Dib, Prathap Tharyan, Esther WY Chan, Jonathan Knott, Celene YL Yap, Célia Mantovani, Marc L. Martel, William G. Honer, Elfriede Scheuring, Gisele Huf, Jacob Alexander, Nirmal S Raveendran, Evandro SF Coutinho, Josef Priller, Clive E Adams, Georgia Salanti, Stefan Leucht · 发表于：The Lancet Psychiatry · 年份：2026 · DOI：10.1016/s2215-0366(26)00097-0 · 被引用次数：1 · 研究领域：Cervical Cancer and HPV Research、Intramuscular injections and effects、Pediatric Pain Management Techniques

BACKGROUND: Several medications are available for rapid tranquilisation in psychomotor agitation, but choosing among them varies across local practices and this variation is compounded by inconsistent guidelines. We performed a systematic review with individual participant data network meta-analysis to inform evidence-based recommendations. METHODS: In this systematic review and individual participant data meta-analysis, we searched multiple databases from database inception to Nov 14, 2025, for randomised trials comparing intramuscular or intravenous treatments for rapid tranquilisation (primary outcome defined as sedation within 15-30 min) in patients with psychomotor agitation in general or psychiatric emergency settings. Anonymised individual participant data were collected and harmonised into a common dataset. Risk of bias was assessed using the RoB 2 tool. We performed Bayesian one-stage random-effects individual participant data network meta-regressions, accounting for between-study heterogeneity, drug classes, prognostic factors, and subgroup effects based on agitation severity. We combined individual participant data and aggregate data to evaluate side-effects. Confidence in the evidence was assessed using the Confidence In Network Meta Analysis (CINeMA) framework. People with lived experience were involved in the design and interpretation of the findings. The protocol was registered with PROSPERO (CRD42023402365). FINDINGS: We included 18 trials across eight regions...