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Pharmacologic Management of Acutely Agitated Pediatric Patients

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Abstract

Acute agitation is a state of behavioral dyscontrol that requires intervention. Medications available in rapid delivery formats are frequently administered to treat acute agitation, either as a chemical restraint or on a voluntary basis. Prior to initiating treatment, the etiology of agitation must be evaluated. In choosing a medication, general pharmacologic principles should be followed. Medication should be selected based on the underlying cause in conjunction with weighing the risks, benefits, and side effects of medications. There are three classes of medications administered to children and adolescents to treat agitation: antihistamines, benzodiazepines, and antipsychotics. The most concerning short-term side effects of antipsychotics are their adverse neurologic effects, neuroleptic malignant syndrome, and prolonged corrected QT interval. Compared with typical antipsychotics, atypical antipsychotics have a more favorable short-term side effect profile.

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Acknowledgements

No sources of funding were used to prepare this manuscript. Loretta Sonnier has no conflicts of interest to declare. Drew Barzman has received consultancy fees from Pfizer and the Pennsylvania Department of Health Reviews; honoraria from AstraZeneca, Bristol Myers Squibb Company, Ostuka America Pharmaceutical, Inc., and the Cincinnati Children’s Hospital Medical Center; and grants from AstraZeneca, Pfizer, the National Alliance for Research on Schizophrenia and Depression (NARSAD), Centers for Education and Research on Therapeutics (CERTs), National Institutes of Health, the Cincinnati Children’s Hospital Medical Center (as a principal investigator or co-investigator), and the American Academy of Psychiatry and the Law (AAPL).

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  1. Department of Child and Adolescent Psychiatry, Child and Adolescent Forensic Psychiatry Service, University of Cincinnati/Cincinnati Children’s Hospital Medical Center (CCHMC), 3333 Burnet Avenue, MLC 5018, Cincinnati, Ohio, 45229, USA

    Loretta Sonnier & Drew Barzman

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  1. Loretta Sonnier
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  2. Drew Barzman
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Correspondence to Loretta Sonnier.

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Sonnier, L., Barzman, D. Pharmacologic Management of Acutely Agitated Pediatric Patients. Pediatr-Drugs 13, 1–10 (2011). https://doi.org/10.2165/11538550-000000000-00000

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