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 .
Effect of nicotine replacement therapy on agitation in smokers with schizophrenia: a double-blind, randomized, placebo-controlled study.
OBJECTIVE The authors conducted a r and omized , placebo-controlled study of nicotine replacement therapy for the reduction of agitation and aggression in smokers with schizophrenia . METHOD Participants were 40 smokers 18 - 65 years of age admitted to a psychiatric emergency service with a diagnosis of schizophrenia confirmed by the Mini International Neuropsychiatric Interview . Patients were screened for agitation with the excited component subscale of the Positive and Negative Syndrome Scale ( PANSS ) and for nicotine dependence with the Fagerström Test for Nicotine Dependence . A score of at least 14 on the PANSS excited component subscale and at least 6 on the Fagerström test were required for study eligibility . Participants in the nicotine replacement group received a 21-mg nicotine transdermal patch , and those in the placebo group were treated with a placebo patch . Participants received usual care with antipsychotics . The Agitated Behavior Scale and other agitation measures were administered at baseline and again at 4 and 24 hours . RESULTS At baseline , participants were at least moderately agitated , and 28 % reported aggressive behavior in the previous week . The mean Agitated Behavior Scale score for the nicotine replacement group was 33 % lower at 4 hours and 23 % lower at 24 hours than for the placebo group . Participants with lower levels of nicotine dependence responded better than those with higher levels of dependence . CONCLUSIONS The drug-placebo difference in this study was similar to that obtained in trials of parenteral antipsychotics in similar population s. This finding suggests that in patients with schizophrenia , smoking status should be included in the assessment of agitation and nicotine replacement included in the treatment of those who are smokers
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 .