Violent patients in the emergency setting.

Violent or threatening behavior is a common reason for presentation to the ED. Patients with aggressive behavior must first be assessed for the possibility of comorbid medical conditions. Acute withdrawal from alcohol or sedatives needs to be ruled out. Short-term sedation with lorazepam is a safe and effective choice for managing patients with acute agitation. The use of typical neuroleptics may lead to side effects, such as akathisia, which may in turn precipitate additional agitation. This may be obviated with the introduction of IM preparations of atypical antipsychotics.