***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Acutely psychotic patients presenting as psychiatric emergencies with aggression or agitation are often administered conventional antipsychotics intramuscularly . However , patients view intramuscular administration as coercive , and conventional antipsychotics are often associated with adverse events . In this open study , consecutive adult patients presenting with an acute exacerbation of schizophrenia or other psychotic disorder were assigned to oral risperidone 2 - 6 mg/day ( n = 48 ) or oral zuclopenthixol 20 - 50 mg/day ( n = 27 ) for 7 - 14 days . Lorazepam ( either oral or intramuscular ) was administered to both groups as needed . Patients were assessed regularly until day 14 or discharge . Mean Positive And Negative Syndrome Scale ( PANSS ) aggression scores ( sum of item scores on excitement , poor impulse control , hostility and uncooperativeness ) decreased steadily and similarly in both groups ; the mean changes from baseline were statistically significant at days 10 and 14 and at study end-point . The mean decrease at study end-point in the PANSS component score for hostility was statistically significant in the risperidone group , but not in the zuclopenthixol group . Social Dysfunction and Aggression Scale aggression scores and Clinical Global Impression scores decreased significantly and similarly in both groups . Overall , 18.7 % of patients showed minor extrapyramidal symptoms during the study , but only 16.7 % of risperidone-treated patients , compared to 59.3 % of zuclopenthixol-treated patients , received anti-parkinsonian medication ( p < 0.001 ) . Lorazepam was administered to all of the patients assigned to risperidone and to 89 % of those assigned to zuclopenthixol . Oral risperidone plus lorazepam is a convenient , effective and well-tolerated alternative to conventional antipsychotics for the treatment of acute psychosis in emergency psychiatry The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas Abstract Intramuscular ( IM ) antipsychotics are preferred for efficient control of agitation symptoms . Previous studies have demonstrated that IM ziprasidone is efficacious and safe for treatment of agitation in schizophrenia . However , clinicians now recognize that racial differences may contribute to altered therapeutic response and tolerability . This study compared the efficacy and tolerability of IM ziprasidone versus IM haloperidol for the management of agitation in Chinese subjects with schizophrenia . Subjects with acute schizophrenia were r and omized to either ziprasidone ( n = 189 , 10 to 20 mg as required up to a maximum of 40 mg/d ) or haloperidol ( n = 187 , 5 mg every 4 to 8 hours to a maximum of 20 mg/d ) for 3 days . Psychiatric assessment s and adverse events were assessed at baseline , 2 , 4 , 24 , 48 , and 72 hours . In the ziprasidone group , 2.1 % of subjects discontinued versus 3.7 % in the haloperidol group . The least squares mean change ( SE ) from baseline to 72 hours in Brief Psychiatry Rating Scale total score was −17.32 ( 0.7 ) for ziprasidone ( n = 167 ) and −18.44 ( 0.7 ) for haloperidol ( n = 152 ) , with a 95 % confidence interval treatment difference of −0.7 to 2.9 . Fewer subjects experienced adverse events after ziprasidone ( n = 54 , 28.6 % ) than haloperidol ( n = 116 , 62.0 % ) , with a notably higher incidence of extrapyramidal symptoms in the haloperidol group ( n = 69 , 36.9 % ) compared to the ziprasidone group ( n = 4 , 2.1 % ) . For controlling agitation in schizophrenia in this Chinese study , ziprasidone had a favorable tolerability profile and comparable efficacy and safety compared to haloperidol OBJECTIVE The objective of this study was to compare the efficacy and side effects of sodium cromoglycate eye drops ( Opticrom 2 % ) used regularly versus as needed in the treatment of seasonal ( ragweed ) allergic conjunctivitis . METHODS A r and omized , unblinded , parallel group comparison was performed during the 6 weeks of the ragweed pollen season . Sixty-two adults with ragweed pollen-induced conjunctivitis were recruited for the study from previous ragweed studies and notices in the local media . Two drops of sodium cromoglycate were placed in each eye either four times daily ( regular treatment group ) or when needed , up to four times daily ( prn group ) , from 1 week before and throughout the ragweed pollen season . Uncontrolled eye symptoms were treated with terfenadine 60 mg as needed , up to 120 mg daily . Subjects kept daily diaries for symptoms and medication requirements throughout the 6 weeks of treatment . The Rhinoconjunctivitis Quality of Life Question naire was administered and adverse experiences were reported after 1 , 3 , and 6 weeks of treatment . RESULTS Diary eye symptoms were similar in the two treatment groups , but quality of life was better in the regular treatment group . There was a trend for the prn group to require more terfenadine for uncontrolled eye symptoms . CONCLUSIONS There may be some additional therapeutic benefit from using sodium cromoglycate eye drops regularly throughout the ragweed pollen season OBJECTIVE This study compared the effects of atypical antipsychotics ( risperidone or quetiapine ) with placebo and with each other in recently exacerbated patients with schizophrenia requiring hospitalization . METHODS This international , r and omized , double-blind study included a 2-week monotherapy phase followed by a 4-week additive therapy phase . Recently exacerbated patients with schizophrenia or schizoaffective disorder ( DSM-IV ) were r and omized ( 2:2:1 ) to risperidone ( n = 153 ) ,  quetiapine ( n = 156 ) , or  placebo ( n = 73 ) . Target doses were 4 or 6 mg/day of risperidone and 400 or 600 mg/day of quetiapine by day 5 , with the ability to increase to 600 or 800 mg/day of quetiapine on day 8 . The main outcome measures were the total Positive and Negative Syndrome Scale ( PANSS ) and need for additional psychotropic medications . RESULTS Monotherapy Phase : The combined atypical antipsychotic group ( n = 308 ) reached borderline superiority to placebo ( n = 71 ) at the 2-week endpoint on mean change in total PANSS score ( -24.1 + /- 1.2 and -20.2 + /- 2.0 , respectively ; p = 0.067 ) . The change in the atypical group was driven by the improvement with risperidone ( -27.7 + /- 1.5 vs. -20.2 + /- 2.0 with placebo , p < 0.01 ; and vs. -20.5 + /- 1.5 with quetiapine , p < 0.01 ) ; the improvement with quetiapine was similar to placebo , p = 0.879 . Results were similar on other efficacy endpoints . Additive Therapy Phase : Additional psychotropics were prescribed to fewer ( p < 0.01 ) risperidone ( 36 % ) than quetiapine ( 53 % ) or placebo patients ( 59 % ) . The overall discontinuation rate was 18 % , 26 % , and 38 % , respectively . Risperidone , compared with placebo , was associated with more parkinsonism , akathisia , plasma prolactin changes , and weight gain ; while quetiapine was associated with more somnolence , sedation , dizziness , constipation , tachycardia , thyroid dysregulation , and weight gain . CONCLUSION While the combined atypical antipsychotic group did not experience greater improvements than the placebo group , risperidone , but not quetiapine , was significantly superior in all measured domains to placebo in the management of recently exacerbated hospitalized patients with schizophrenia or schizoaffective disorder , with no unexpected tolerability findings We conducted a prospect i ve double-blind study of accelerated dose titration of olanzapine in the treatment of newly admitted acutely agitated patients with schizophrenia . Patients were r and omized to either oral olanzapine ( 10 mg per day ) or oral haloperidol ( 10 mg per day ) , plus lorazepam as needed ( up to 12 mg per day ) . Antipsychotic dosage was increased to 20 mg per day as early as day 3 . Patients were evaluated with the Positive and Negative Syndrome Scale ( PANSS ) Agitation subscale during the first 24 hours of treatment , daily for the first week , then weekly until study completion . Significant within-group improvement was demonstrated in PANSS Agitation scores for both groups as early as 1 hour after initiating therapy ( -5.79 + /- 6.30 for olanzapine and -4.89 + /- 6.05 for haloperidol , P < .001 ) . This study demonstrated that accelerated dose titration of oral olanzapine is as efficacious as oral haloperidol in reducing acute agitation in patients with schizophrenia Background Patients experiencing an acute decompensation of schizophrenia or bipolar disorder often present in an agitated state . Agitation presents a barrier to therapy , interrupting the typical physician-patient alliance and creating a disruptive , even hazardous , environment . Rapid assessment and effective treatment are necessary to manage agitation and , potentially , to shorten the time to recovery . Methods One hundred forty-eight acutely agitated patients received either : rapid initial dose escalation ( RIDE ) in which up to 40 mg of oral olanzapine was allowed on days 1 and 2 , up to 30 mg on days 3 and 4 , and 5 to 20 mg thereafter ; or usual clinical practice ( UCP ) in which patients received 10 mg/d olanzapine plus up to 4 mg lorazepam on days 1 and 2 , up to 2 mg on days 3 and 4 , and olanzapine 5 to 20 mg/d thereafter . The Positive and Negative Syndrome Scale-Excited Component ( PANSS-EC : poor impulse control , tension , hostility , uncooperativeness , and excitement ) measured at 24 hours was the primary measure . Secondary assessment s of agitation and safety were also performed . Results Agitation improved significantly from baseline for both treatment groups ; however , improvement with the RIDE strategy was superior to UCP . The RIDE group improvement was superior on the primary efficacy measure ( PANSS-Excited ) at 24 hours ; it was superior on all agitation measures at the end of double-blind treatment . Both treatments were well tolerated , with no clinical ly significant differences in safety measures . Treatment was not limited by oversedation and attention improved from baseline in both groups . Conclusions This study demonstrates the value of olanzapine in the treatment of acutely agitated patients . A new approach to olanzapine dosing that exp and s the initial dose range up to 40 mg/d may offer superior efficacy in rapidly and effectively controlling the symptoms of agitation BACKGROUND There is a clear need for effective , well-tolerated intramuscular ( i.m . ) agents for the acute control of agitated psychotic patients . Currently used agents , including conventional antipsychotics and /or benzodiazepines , may be associated with distressing side effects such as extrapyramidal side effects and excessive sedation . OBJECTIVE The objective of this study was to evaluate the efficacy and tolerability of the rapid-acting i.m . formulation of the novel antipsychotic ziprasidone in the treatment of in patients with psychosis and acute agitation ( DSM-IV diagnoses ) . METHOD In a 24-hour , double-blind , fixed-dose clinical trial , patients were r and omly assigned to receive up to 4 injections ( every 2 hours p.r.n . ) of 2 mg ( N = 54 ) or 10 mg ( N = 63 ) of ziprasidone i.m . The Behavioral Activity Rating Scale measured behavior 
    Output:
    
Our main outcomes of interest were important changes in ( i ) mental state , ( ii ) behaviour , ( iii ) dose of medication used , ( iv ) adverse events , ( v ) satisfaction with care and ( iv ) cost of care .