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 retrospective analysis of intramuscular haloperidol and intramuscular olanzapine in the treatment of agitation in drug- and alcohol-using patients.
OBJECTIVE The treatment of agitation in drug- and alcohol-using emergency patients is understudied . METHOD We performed a retrospective chart review of 105 agitated emergency department patients who received either intramuscular ( IM ) haloperidol or IM olanzapine  , comparing prescribing patterns , level of agitation , response to treatment and side effects in patients positive for drugs or alcohol [ D/A(+ ) ] and patients negative for drugs or alcohol [ ( D/A(- ) ] . RESULTS The haloperidol-benzodiazepine combination was the most frequently prescribed treatment in both groups , although alcohol(+ ) status biased clinicians toward using haloperidol alone . Overall , D/A(+ ) and D/A(- ) patients responded to the initial intervention at similar rates , although D/A(+ ) patients were rated as more agitated and had more posttreatment sedation than D/A(- ) patients . In D/A(+ ) patients , haloperidol+benzodiazepine and IM olanzapine performed better than haloperidol alone . There were no serious adverse events with any treatment . CONCLUSION Findings support the generalization of efficacy data from more rarified agitated sample s to population s with high rates of substance use and highlight the need for prospect i ve , inclusive , r and omized trials comparing the commonly used haloperidol-benzodiazepine combination with newer injectable antipsychotics
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 .