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 .
Intramuscular aripiprazole or haloperidol and transition to oral therapy in patients with agitation associated with schizophrenia: sub-analysis of a double-blind study*
ABSTRACT Objective : A sub- population analysis of 325 patients with agitation ( Positive and Negative Syndrome Scale Excited Component [ PEC ] score ≥ 15 and ≤ 32 ; score of ≥ 4 on ≥ 2 items ) associated with schizophrenia in a r and omized , double-blind study investigating the efficacy and tolerability of intramuscular ( IM ) aripiprazole 9.75 mg , IM haloperidol 6.5 mg , or IM placebo and the transition to oral therapy . Research design and methods : Over 24 h , patients could receive up to three IM injections ; the second and third administered ≥ 2 and ≥ 4 h , respectively , after the first , if deemed clinical ly necessary . Following IM treatment , oral aripiprazole or haloperidol was administered for 4 days . The primary efficacy measure was the mean change in PEC score from baseline at 2 h. Results : At 2 h , mean improvements in PEC scores with IM aripiprazole ( –8.0 ) were significantly greater versus IM placebo ( –5.7 ; p ≤ 0.01 ) , and similar versus IM haloperidol ( –8.3 ) . Secondary efficacy measures also significantly improved with active IM treatment versus IM placebo . Continuation with oral treatment provided continued efficacy with both active treatments . The safety profiles of IM and oral aripiprazole were similar . The incidence of extrapyramidal symptom-related adverse events was 0 % with IM aripiprazole , 1.6 % with IM placebo and 16.5 % with IM haloperidol . Conclusion : Intramuscular aripiprazole is effective in patients with acute agitation associated with schizophrenia , comparable to IM haloperidol , and enables convenient transfer to oral aripiprazole therapy
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 .