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 .
Intramuscular olanzapine vs. intramuscular short-acting antipsychotics: safety, tolerability and the switch to oral antipsychotic medication in patients with schizophrenia or acute mania.
BACKGROUND This study compared the safety , tolerability and switch to oral medication in patients with bipolar disorder or schizophrenia who received intramuscular ( IM ) olanzapine or other IM antipsychotics for the treatment of acute agitation . METHODS Patients ( N = 2011 ) from 15 countries participated in this prospect i ve , observational , non-interventional study . In patients requiring treatment with at least one IM injection of a short-acting antipsychotic  were assessed at baseline and within 7 days after the first IM injection . Treatment groups comprised : ( i ) patients prescribed IM olanzapine at baseline ; and ( ii ) patients prescribed any other IM antipsychotic medication at baseline . Outcome measures included : treatment-emergent adverse events , concomitant psychotropic medication and the time taken to switch to oral medication . RESULTS Fewer patients in the IM olanzapine group experienced an adverse event than patients in the other IM antipsychotic group ( 34.4 % vs. 46.2 % , p < 0.001 ) . The most frequently reported adverse events in both groups were : sedation , Parkinsonism , disturbance in attention , akathisia , dystonia and orthostatic hypotension . Fewer patients in the IM olanzapine group used anticholinergics ( 13.9 % vs. 42.5 % , p < 0.001 ) or anxiolytics/hypnotics ( 47.6 % vs. 51.6 % , p = 0.023 ) . Patients in the IM olanzapine group switched to oral medication earlier than patients in the other IM antipsychotic group ( median time = 46.5 vs. 48.0 h , p = 0.009 ) . CONCLUSIONS These findings suggest that IM olanzapine may have a favourable impact on individual patients . However , the high rate of oral concomitant medication used throughout the study limits these findings from being associated with IM olanzapine alone
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 .