Medications Used for Agitated or Violent Patients

Antipsychotics

AripiprazoleAripiprazole

Response to aripiprazole should be monitored in patients taking medications that decrease (carbamazepine) or increase (fluoxetine, paroxetine) plasma levels.Response to aripiprazole should be monitored in patients taking medications that decrease (carbamazepine) or increase (fluoxetine, paroxetine) plasma levels.

HaloperidolHaloperidol

Haloperidol is usually required only if a diagnosis of psychosis has been made. The medication can make some substance intoxications (eg, with phencyclidine) worse and may cause dystonia. Haloperidol is usually required only if a diagnosis of psychosis has been made. The medication can make some substance intoxications (eg, with phencyclidine) worse and may cause dystonia.

A liquid concentrate, which has rapid absorption may be used if the patient can take the medication orally.

Respiratory depression does not occur.

OlanzapineOlanzapine

Some clinicians give the medication IV in 5-mg doses.

ZiprasidoneZiprasidone

ECG monitoring may be needed.

Concomitant use with carbamazepine and ketoconazole should be avoided.Concomitant use with carbamazepine and ketoconazole should be avoided.

Benzodiazepines

LorazepamLorazepam

IV is preferred because absorption from IM injection may be erratic.

Respiratory depression is possible.

MidazolamMidazolam

IV is preferred because absorption from IM injection may be erratic.

Respiratory depression is possible.