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 .
Effective resolution with olanzapine of acute presentation of behavioral agitation and positive psychotic symptoms in schizophrenia.
Behavioral agitation and prominent positive psychotic symptoms often characterize the acute presentation of schizophrenia . The clinical treatment goal is a rapid control of these symptoms . The relative efficacy of olanzapine , a novel antipsychotic drug , was compared with that of the conventional antipsychotic drug haloperidol . A post hoc analysis conducted on a large multicenter , double-blind , 6-week study of acute-phase patients with DSM-III-R schizophrenia or schizophreniform or schizoaffective disorders treated with olanzapine ( 5 - 20 mg/day ) or haloperidol ( 5 - 20 mg/day ) assessed the treatment effects on agitation ( Brief Psychiatric Rating Scale [ BPRS ] agitation score ) and positive symptoms ( BPRS positive symptom score ) . Overall , olanzapine-treated patients experienced significantly greater improvement in behavioral agitation than did haloperidol-treated patients ( last observation carried forward [ LOCF ] ; p < .0002 ) . Both groups showed similar reductions in agitation scores during the first 3 weeks of therapy ; olanzapine was associated with significantly greater improvements at weeks 4 , 5 , and 6 ( observed cases [ OC ] ) . Similarly , patients with predominantly positive psychotic symptoms experienced significantly greater improvement in BPRS positive symptom scores with olanzapine compared with haloperidol ( LOCF ; p = .013 ) . In olanzapine-treated patients , improvement in BPRS agitation and positive symptom scores was significantly greater at weeks 4 , 5 , and 6 ( agitation scores , p < or = .01 ; positive symptom scores , p < .05 ) ( OC ) . These data suggest that olanzapine may be considered a first-line treatment for the patient in an acute episode of schizophrenia
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 .