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 .
Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder.
BACKGROUND Aripiprazole is an investigational agent for treating schizophrenia that has a novel pharmacologic profile . The present study investigated the efficacy , safety , and tolerability of aripiprazole and haloperidol compared with placebo . METHOD A 4-week , double-blind , r and omized study , conducted at 36 U.S. centers between July 1997 and June 1998 , compared aripiprazole ( 15 mg/day , 30 mg/day ) to placebo , with haloperidol ( 10 mg/day ) as an active control . Fixed doses of each agent were administered from day 1 throughout the study . A total of 414 patients with a primary DSM-IV diagnosis of schizophrenia or schizoaffective disorder were r and omized .  Efficacy measures included the Positive and Negative Syndrome Scale ( PANSS ) total , PANSS positive , PANSS negative , PANSS-derived Brief Psychiatric Rating Scale ( BPRS ) core , Clinical Global Impressions (CGI)-Severity of Illness , and mean CGI-Improvement scores . Safety and tolerability evaluations included extrapyramidal symptoms ( EPS ) , weight gain , serum prolactin level , and QTc interval . RESULTS Both doses of aripiprazole and haloperidol , 10 mg , produced statistically significant ( p < or = .05 ) improvements from baseline in PANSS total , PANSS positive , PANSS-derived BPRS core , and CGI-Severity scores and significantly lower CGI-Improvement scores at endpoint , compared with placebo . Aripiprazole , 15 mg , and haloperidol , 10 mg , significantly improved PANSS negative score compared with placebo . Both aripiprazole doses and haloperidol separated from placebo for PANSS total scores at week 2 . Unlike haloperidol , aripiprazole was not associated with significant EPS or prolactin elevation at endpoint compared with placebo . There were no statistically significant differences in mean changes in body weight across the treatment groups versus placebo , and no patients receiving aripiprazole experienced clinical ly significant increases in QTc interval . CONCLUSION Aripiprazole , effective against positive and negative symptoms , is a safe and well-tolerated potential treatment for schizophrenia and schizoaffective disorder
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 .