AGItated Patients Management: intraNASAL Midazolam vs Intramuscular Loxapine

Who can take part

• Age 18 to 60 years
• Agitated Patient whose somatic or psychiatric aetiology cannot be diagnosed in an emergency situation and who need a sedation in a hospital emergency setting due to the presence of unmanageable agitation with 3 major criteria; Major criteria :; Agitation Pain Tolerance Tachypnea ( fr > 20); And 1 minor criteria among :; Sweating Tactile Hyperthermia Medical care Non compliance Lack of tiring Unusual Strenght Inappropriately clothed, nudity
• Medical insurance The protocol can start if the THREE major inclusion criteria and ONE of the minor inclusion criteria are checked PRESENT and ALL the non-inclusion criteria are checked no

Who cannot take part

• Contraindications to intranasal Midazolam or intramuscular Loxapine :; Hypersensitivity to benzodiazepines or to any of the excipients (Sodium Chloride, Hydrochloric Acid, Sodium Hydroxide, Water for Injection); Known hypersensitivity to loxapine or to any of the excipients (Polysorbate 80, propylene glycol, 20% v/v hydrochloric acid, water for injections, Nitrogen (Inert gas); Individuals who are in comatose states or have central nervous system (CNS) depression due to alcohol or are taking other depressant drugs; Individuals with severe depressive states, spastic diseases, and with Parkinson's disease, except in the case of dyskinesias due to levodopa treatment; In combination with dopamine agonists except levodopa (amantadine, bromocriptine, lisuride, pergolide, piribedil, ropinirole, cabergoline, pramipexole, apomorphine) outside the patient with Parkinson's disease; Individuals with a history of cerebrovascular accident or epilepsia; Individuals in whom a significant elevation of blood pressure would constitute a serious hazard, such as patients with significant hypertension; Individuals with severe cardiac decompensation; Patients with severe respiratory failure or acute respiratory depression; Individuals with acute narrow angle glaucoma
• Subjects who meet any of the following criteria will be excluded from randomization into the study:
• Pregnancy
• Prisoners