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 comparison of parenteral loxapine and haloperidol in hostile and aggressive acutely schizophrenic patients.
In a parallel groups , double-blind study , 54 acutely psychotic schizophrenics were given loxapine or haloperidol parenterally for 24 to 72 hours , then orally for a total study period of up to 10 days . Dosage ratios of loxapine to haloperidol ranged from a minimum of 2.7:1 to a maximum of 4.4:1 . Both groups showed significant and rapid improvement from baseline . Forty-eight percent of the loxapine patients and 33 % of the haloperidol patients achieved and maintained a global severity of illness rating of mild or better . By the end of the study , 84 % of the loxapine patients and 63 % of the haloperidol patients had achieved an improvement rating of moderate or marked . This difference approached significance ( p less than .10 ) . The most frequently reported adverse experiences were dystonic reactions and akathisia . The number and severity of adverse experiences did not differ significantly between drug groups . Intramuscular loxapine was at least as effective as haloperidol in the initial management of hostile and aggressive schizophrenic patients . The maintenance of therapeutic response after conversion to oral concentrate was comparable with the two drugs
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 .