Table 2.

Pharmacological management.

Therapeutic Domain	Evidence Base	Typical Dose Range Reported	Key Findings
Benzodiazepines (BZDs)	27/35 manuscripts, >700 pts	IV/IM lorazepam (2–6 mg), diazepam (10 mg TID), midazolam (1 mg)	Universal first-line agent for agitation, convulsions, or catatonia. As a monotherapy, it achieved full clinical resolution of mild-to-moderate intoxications within 6–24 h.
Typical antipsychotics	10/35 manuscripts (mainly from Eastern Europe)	Haloperidol (5–30 mg/day), IM chlorpromazine	Effective for florid psychosis but required high doses and close QT/EP symptom monitoring.
Second-generation antipsychotics (SGAs)	22/35 manuscripts	Olanzapine (10–20 mg/day), risperidone (2–6 mg/day), aripiprazole (10–20 mg/day)	Favored in Western cohorts; usually started after BZD. Time to remission: 24–72 h. Adherence problems prompted two reports of LAI paliperidone.
Clozapine	3 resistant cases	50–150 mg/day (adult), 12.5–50 mg/day (older PD patient)	Robust improvement where ≥2 other antipsychotics failed. Effective at lower doses than in primary schizophrenia.
Anesthetic agents	2 case series/reports	Propofol bolus/infusion	Enabled surgical airway or globe-repair procedures after extreme agitation or self-injury.
Detox/supportive care	Pediatric and ED cohorts	IV crystalloids, oxygen, B vitamins	In total, 70% of 1898 ED attendees required no psychotropics once hydrated and observed in a low-stimulus setting.

Abbreviations: BZDs = benzodiazepines; IV = intravenous; IM = intramuscular; TID = three times daily; SGAs = second-generation antipsychotics; LAI = long-acting injectable; PD = Parkinson’s disease; ED = emergency department; QT = QT interval; EP = extrapyramidal.