Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.47626/2237-6089-2022-0571
Trends in Psychiatry and Psychotherapy
Review Article

Brazilian Psychiatric Association Consensus for the Management of Acute Intoxication: general management and specific interventions for drugs of abuse

Leonardo Baldaçara, Amanda de Gouvêa Pettersen, Verônica da Silveira Leite, Flávia Ismael, Carolina Pereira Motta, Railson Alves Freitas, Nicoli Abrazo Fasanella, Lucas Alves Pereira, Maria Elisa Lima Barros, Leonardo Barbosa, Ana Luiza Silva Teles, Ruy Palhano, Helio Penna Guimaraes, Maria Aparecida Braga, João Mauricio Castaldelli-Maia, Carla Bicca, Analice Gligliotti, Ana Cecilia Petta Roseli Marques, Antônio Geraldo da Silva

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Abstract

Objectives
To present the Brazilian Psychiatric Association’s Consensus on the Management of Acute Intoxication.

Methods
A group of experts selected by the Brazilian Psychiatric Association searched for articles on the MEDLINE (by PubMed) and Cochrane databases, limited to human studies and acute intoxication. Working groups reviewed these materials for appropriateness to the topic and the quality of the work. A survey was conducted using the Delphi method to produce a table of agreed recommendations presented at the end of the systematic review. Three survey rounds were held to reach consensus.

Results
Support for intoxication should start with Initial Management: Resuscitation/Life Support/Differential Diagnosis. For this, the group proposed the following sequence of assessments: A (airway), B (breathing), C (circulation), D.1 (disability), D.2 (differential diagnosis), D.3 (decontamination), D.4 (drug antidotes), E (enhanced elimination). The group of experts then presented specific interventions for the main drugs of abuse.

Conclusions
Management of intoxication with drugs of abuse is complex and requires systematic protocols. The group suggests adoption of the A-B-C-D-E technique first, with constant investigation. Then, specific conduct and support until remission of intoxication. The literature is still scarce in evidence on the subject. Therefore, this consensus was necessary. We believe that at present this document can help psychiatric, general, and emergency physicians deal with emergency psychiatric episodes due to acute intoxication. This work could stimulate future studies on the topic.

Keywords

Poisoning; emergencies; drug abuse; detoxification; acute intoxication

Submitted date:
09/18/2022

Accepted date:
11/19/2022

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