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 .
Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder.
BACKGROUND Aripiprazole is a dopamine D2 receptor partial agonist with partial agonist activity at serotonin 5HT1A receptors and antagonist activity at 5HT2A receptors . This multicenter trial examined the efficacy , safety , and tolerability of aripiprazole in patients with acute exacerbation of schizophrenia or schizoaffective disorder . METHODS In this 4-week double-blind study , 404 patients were r and omized to 20 mg/d ( n = 101 ) or 30 mg/d ( n = 101 ) of aripiprazole , placebo  ( n = 103 ) , or 6 mg/d of risperidone  ( n = 99 ) . Efficacy assessment s included Positive and Negative Syndrome Scale ( PANSS ) scores and Clinical Global Impression scores . Safety and tolerability evaluations included extrapyramidal symptoms and effects on weight , prolactin , and corrected QT ( QTc ) interval . RESULTS Aripiprazole ( 20 and 30 mg/d ) and risperidone ( 6 mg/d ) were significantly better than placebo on all efficacy measures . Separation from placebo occurred at week 1 for PANSS total and positive scores with aripiprazole and risperidone and for PANSS negative scores with aripiprazole . There were no significant differences between aripiprazole and placebo in mean change from baseline in the extrapyramidal symptom rating scales . Mean prolactin levels decreased with aripiprazole but significantly increased 5-fold with risperidone .  Mean change in QTc interval did not differ significantly from placebo with any active treatment group . Aripiprazole and risperidone groups showed a similar low incidence of clinical ly significant weight gain . CONCLUSIONS Aripiprazole is effective , safe , and well tolerated for the positive and negative symptoms in schizophrenia and schizoaffective disorder . It is the first non-D2 receptor antagonist with clear antipsychotic effects and represents a novel treatment development for psychotic disorders
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 .