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 .
Double-blind, placebo-controlled comparison of intramuscular olanzapine and intramuscular haloperidol in the treatment of acute agitation in schizophrenia.
OBJECTIVE The authors evaluated the comparative efficacy and safety of intramuscular olanzapine , intramuscular haloperidol , and intramuscular placebo for the treatment of acute agitation in schizophrenia . METHOD Hospitalized patients with schizophrenia received one to three injections of intramuscular olanzapine , 10 mg , intramuscular haloperidol , 7.5 mg , or intramuscular placebo over a 24-hour period . Agitation was measured with the excited component of the Positive and Negative Syndrome Scale and two additional scales . RESULTS According to scores on the excited component of the Positive and Negative Syndrome Scale , both intramuscular olanzapine and intramuscular haloperidol reduced agitation significantly more than intramuscular placebo 2 and 24 hours following the first injection . Intramuscular olanzapine reduced agitation significantly more than intramuscular haloperidol 15 , 30 , and 45 minutes following the first injection . No patients treated with intramuscular olanzapine experienced acute dystonia , compared with 7 % of those who were treated with intramuscular haloperidol . No significant QT(c ) interval changes were observed in any patients . CONCLUSIONS Intramuscular olanzapine represents a rapid , effective , and safe treatment for acute agitation in 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 .