For psychotic agitation, if initial antipsychotic is ineffective, addition of a benzodiazepine is preferred over additional doses of antipsychotic. However, do not combine IM olanzapine with IM lorazepam due to the risk of respiratory depression.
Some people find that complementary and alternative therapies help to manage their symptoms. For example, this may be aromatherapy, reflexology or acupuncture. Complementary therapies may also help manage some of the side effects of medication, if you decide to continue with it.
For the purpose of tranquilizing acutely agitated patients, the drugs of choice are the benzodiazepines for which a parenteral formulation is available, namely lorazepam and diazepam. Lorazepam is generally preferred as it has a more predictable onset and duration of action, while also lacking active metabolites.
Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).
Medication Options
Benzodiazepines may be satisfactory as monotherapy in cases of mild agitation, but antipsychotics are preferred in more severe cases. The combination of an antipsychotic and a benzodiazepine is usually more effective than either agent alone.
SSRIs that have been shown to help with anger include citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), among others. Sertraline seems to have the most supporting data. Other classes of antidepressants, like serotonin norepinephrine reuptake inhibitors (SNRIs), aren't widely used for treating anger.
For agitation in adult patients with psychiatric conditions, the consensus is to use antipsychotic first or second-generation monotherapy for both management of agitation and initial drug therapy for patients with known mental illness for which antipsychotics are indicated.
The most prominent of anti-anxiety drugs for the purpose of immediate relief are those known as benzodiazepines; among them are alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan).
Midazolam. Midazolam (brand name: Versed) is a medication used to help ease anxiety. This medication is a Benzodiazepine, it belongs to the same family as Valium, and it can be given orally or intravenously.
If agitation is mild, it is reasonable to start with 0.5–2.5 mg of IV haloperidol, if it is moderate, 5–10 mg IV is given, and if severe, 10 mg IV is given at the outset. The clinician should adjust the dose to the clinical course, and IV doses can be repeated every 15–30 minutes until calm is achieved.
The patient will commonly be started on a small dose of sedative (such as a benzodiazepine like midazolam or lorazepam). They may also be given an anti-psychotic (such as haloperidol). Medicines are usually given as injections or through a syringe pump (also known as a syringe driver).
Some studies suggest that glycine, sarcosine, NAC, several Chinese and ayurvedic herbs, ginkgo biloba, estradiol, and vitamin B6 may be effective for psychotic symptoms when added to antipsychotics (glycine not when added to clozapine).
The short answer is “yes.” A person has a constitutional right to refuse medication and other forms of medical treatment, and that includes the right of parents to refuse to allow that their children be medicated.
A second therapeutic candidate, LYT-310 (oral cannabidiol), is expected to enter the clinic in Q4 of 2023. A second therapeutic candidate, LYT-310 (oral cannabidiol), is expected to enter the clinic in Q4 of 2023.
Antipsychotics are commonly prescribed to help with symptoms such as hallucinations, delusions, or racing thoughts, but can also be prescribed for individuals without those symptoms. Some antipsychotics are considered mood stabilizers because they, too, even out the highs and lows.
There are several over-the-counter options for managing anxiety. Here are some natural herbs and supplements that may help: Magnesium: Magnesium helps regulate neurotransmitters and reduces symptoms of anxiety. Ashwagandha: Ashwagandha is an adaptogenic herb that helps the body cope with stress.
Agitation often occurs alongside depression, but it can also be a feature of bipolar disorder, schizophrenia, dementia, and other conditions — some of which can also involve depression. Agitation can also occur with substance abuse disorder, personality disorder, autism, and other conditions.
It's common to feel irritable from time to time, but if you feel unusually irritable or irritable all the time or on edge, it is important that you talk to your doctor as it could be a symptom of a mental health condition, like depression, anxiety or bipolar disorder, or a physical condition.
What Is Agitation? Agitation is a feeling of uneasiness, aggravation or restlessness that can be brought on by little or no provocation. It is usually accompanied by physical actions such as wringing of the hands or pacing, or talking excessively, which are known as psychomotor agitation.