Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010) were examined.Chemical restraint was applied in 33 cases (10.5% of total admissions). From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases), usually in combination with a benzodiazepine (61.7% of cases). In 36.4% of cases the patient was further subjected to restraint or seclusion.In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.Coercive measures are commonly used in psychiatric treatment for the management of behaviour in patients who are disturbed, although the need for alternatives has been widely recognised [1]. Most authors focus on seclusion and physical restraint, whereas chemical (pharmaceutical) restraint or rapid tranquilisation has gained little attention in the recent literature. We have previously reported on the practice of restraint and seclusion in Greece [2] and the patients and families attitudes towards coercive measures [3]. Here, we report on the practice of chemical restraint in a psychiatric ward within a general hospital.A total of 314 admissions in the 11-bed psychiatric ward of the General Hospital of Arta in northwestern Greece from a 2-year-period (March 2008 to March 2010) were examined retrospectively. Rapid tranquilisation (defined as emergency intramuscular drug administration for the management of patients' acute agitation and violent behaviour) was appli