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 .
Multiple fixed doses of “Seroquel” (quetiapine) in patients with acute exacerbation of schizophrenia: A comparison with haloperidol and placebo
Five fixed doses of the atypical antipsychotic " Seroquel " ( quetiapine ) were evaluated to delineate a dose-response relationship , as measured by changes from baseline in Brief Psychiatric Rating Scale ( BPRS ) , Clinical Global Impression ( CGI ) , and Modified Scale for the Assessment of Negative Symptoms ( SANS ) summary scores , and to compare efficacy and tolerability opposite placebo and haloperidol .  Three hundred sixty-one patients from 26 North American centers entered this double-blind , placebo-controlled trial with acute exacerbation of chronic schizophrenia ( DSM-III-R ) . Patients who completed a single-blind , placebo washout phase were r and omized to double-blind treatment with quetiapine ( 75 , 150 , 300 , 600 , or 750 mg daily ) , haloperidol ( 12 mg daily ) , or placebo and evaluated weekly for 6 weeks . At end point , significant differences ( p < 0.05 , analysis of covariance ) in adjusted mean changes from baseline were identified between the four highest doses of quetiapine and placebo for BPRS total , BPRS positive-symptom cluster , and CGI Severity of Illness item scores and between quetiapine 300 mg and placebo for SANS summary score . Differences between quetiapine and haloperidol were not significant . Dose-response modeling showed significant linear and quadratic functions of quetiapine dose for all primary efficacy variables . Notably , no significant safety concerns were identified as dose increased . Quetiapine was no different from placebo across the dose range studied regarding incidence of extrapyramidal symptoms or change in prolactin concentrations .  Quetiapine is well tolerated and clinical ly effective in the treatment of schizophrenia . It is both superior to placebo and comparable to haloperidol in reducing positive symptoms at doses ranging from 150 to 750 mg/day and in reducing negative symptoms at a dose of 300 mg/day
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 .