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 .
Rapid acute treatment of agitation in individuals with schizophrenia: multicentre, randomised, placebo-controlled study of inhaled loxapine.
BACKGROUND There is a need for a rapid-acting , non-injection , acute treatment for agitation . AIMS To evaluate inhaled loxapine for acute treatment of agitation in schizophrenia . METHOD This phase III , r and omised , double-blind , placebo-controlled , parallel-group study ( Clinical Trials.gov number NCT00628589 ) enrolled 344 individuals who received one , two or three doses of inhaled loxapine ( 5 or 10 mg ) or a placebo . Lorazepam rescue was permitted after dose two . The primary efficacy end-point was change from baseline in Positive and Negative Syndrome Scale-Excited Component ( PANSS-EC ) 2 h after dose one . The key secondary end-point was Clinical Global Impression-Improvement scale ( CGI-I ) score 2 h after dose one . RESULTS Inhaled loxapine ( 5 and 10 mg ) significantly reduced agitation compared with placebo as assessed by primary and key secondary end-points . Reduced PANSS-EC score was evident 10 min after dose one with both 5 and 10 mg doses . Inhaled loxapine was well tolerated , and the most common adverse events were known effects of loxapine or minor oral effects common with inhaled medications . CONCLUSIONS Inhaled loxapine provided a rapid , well-tolerated acute treatment for agitation in people with 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 .