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 .
A naturalistic comparison study of the efficacy and safety of intramuscular olanzapine, intramuscular haloperidol, and intramuscular levomepromazine in acute agitated patients with schizophrenia.
OBJECTIVE This study was a comparative investigation of the clinical efficacy and safety of intramuscular ( IM ) olanzapine , IM haloperidol , and IM levomepromazine in acute agitated patients with schizophrenia . METHODS The subjects were 122 in patients . Their clinical symptoms were assessed using Positive and Negative Syndrome Scale Excited Component ( PANSS-EC ) , PANSS , and Agitation-Calmness Evaluation Scale , and their safety were assessed using the Abnormal Involuntary Movement Scale , Barnes Akathisia Rating Scale ( BARS ) , and Drug-induced Extrapyramidal Symptoms Scale ( DIEPSS ) . RESULTS The mean changes from baseline on the PANSS-EC , Agitation-Calmness Evaluation Scale , Abnormal Involuntary Movement Scale , BARS , and DIEPSS scores were significantly better in both IM olanzapine and IM levomepromazine than in IM haloperidol . Of these , the mean changes from baseline on the BARS and DIEPSS scores were significantly better in IM olanzapine than in IM levomepromazine . The mean change from baseline on the PANSS positive score was significantly better in both IM olanzapine and IM haloperidol than in IM levomepromazine . CONCLUSIONS The results of this study suggest the possibility that the anti-agitation effects of IM olanzapine and IM levomepromazine are more rapid than those of IM haloperidol . No worsening of EPS was observed . Our results also suggest that compared with IM levomepromazine , IM olanzapine is safer and affords greater improvement in symptoms
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 .