For its management , experts agreed in considering  verbal de-escalation  and  environmental modification techniques  as first choice , considering physical restraint as a last resort strategy .
BACKGROUND Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry .
Current recommendations on agitation in psychiatry are not univocal .
Actually , an improper assessment and management may result in unnecessary coercive or sedative treatments .
A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions .
Methamphetamine toxicity: treatment with a benzodiazepine versus a butyrophenone.
Patients with methamphetamine toxicity often present to the emergency department ( ED ) agitated , violent and psychotic . To determine the efficacy of a benzodiazepine versus a butyrophenone for chemical restraint we conducted a prospect i ve , r and omized study at a large urban university ED between January 1995 and January 1997 . Patients were r and omized to receive either lorazepam or droperidol intravenously . A 6-point sedation scale was devised , with 6 representing extreme agitation and 1 deep sleep . Sedation scores were recorded at time 0 , 5 , 10 , 15 , 30 and 60 min . Vital signs were recorded at time 0 and at 60 min . If sedation was inadequate , repeat dosages of each drug could be repeated at 30 min . Toxicology screen , ethanol and creatinine phosphokinase levels were obtained . A total of 146 patients were evaluated . Seventy-four patients received lorazepam  and 72 received  droperidol . Both drugs had similar sedation profiles at 5 min . Patients receiving droperidol had significantly improved sedation scores at times 10 , 15 , 30 and 60 min than lorazepam ( p < 0.001 ) . More repeat doses of lorazepam were given ( 26 ) than droperidol ( 6 ) at 30 min . Both drugs produced significant reduction in pulse , systolic blood pressure , respiratory rate , and temperature over 60 min . We conclude droperidol produces a more rapid and profound sedation than lorazepam for methamphetamine toxicity . Lorazepam is more likely to require repeat dosing than droperidol
For its management , experts agreed in considering  verbal de-escalation  and  environmental modification techniques  as first choice , considering physical restraint as a last resort strategy .
BACKGROUND Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry .
Current recommendations on agitation in psychiatry are not univocal .
Actually , an improper assessment and management may result in unnecessary coercive or sedative treatments .
A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions .