ABSTRACT
The patient that is agitated for reasons secondary to personality factors can often be negotiated with so that their behavior is no longer scary, dangerous, or blocking the ability for them to be cared for optimally. Since the patient is likely to be in the beginning stages of the medical work up, the medical chart is unlikely to be terribly helpful in elucidating the cause of delirium. Typical and atypical antipsychotics have been shown to be effective in the management of acute agitation, regardless of whether the agitation is due to dementia or delirium. With respect to the typical antipsychotics, potency does not predict performance in the treatment of agitation. If non-pharmacologic interventions are ineffective, it is time to start thinking about medications to help increase safety. The vast majority of agitation cases in the emergency department (ED) can be managed with one agent.
