Rationale and Guidelines for the Inpatient Treatment of Acute Psychosis

For patients hospitalized with acute episodes of psychosis, rapid stabilization of intense positivesymptoms, hostility, and agitation is typically a preeminent therapeutic goal. These goals often differfrom those of the nonhospitalized patient with psychosis for whom long-term treatment goals such asimprovement of negative symptoms, cognitive function, compliance, and reduction in side effect burdenmay be paramount. Therefore, when selecting an antipsychotic treatment for hospitalized patients,efficacy against positive symptoms and hostility as well as speed of therapeutic onset shouldstrongly be considered. At the same time, selection of antipsychotic treatment in the inpatient settingshould establish a definitive treatment that will address long-term goals effectively after discharge.This article presents the rationale and practical guidelines for selection of treatment regimens for patientshospitalized due to acute psychosis.