Mental Health Clinician · Published 2026-06-01 · DOI 10.9740/mhc.2026.06.135
Michelle Yang, Christine M. Rarrick, Clint Ross
Introduction Pro re nata (PRN) medications can be administered for the treatment of agitation. Evidence-based recommendations for the pharmacologic treatment of agitation in children and adolescents admitted to a behavioral health unit are limited. The primary objective of this study was to analyze medication use patterns for managing agitation in a pediatric and adolescent inpatient behavioral health unit. The secondary objective was to evaluate the effectiveness and safety of commonly administered PRN medications in this population. Methods This retrospective chart review included patients who received a 1-time or PRN medication for agitation while admitted to a pediatric and adolescent behavioral health unit between July 1, 2020, and June 31, 2022. Primary outcomes examined agents administered and the route and rate of concurrent medication administration. Secondary outcomes included administration of subsequent medications, the use of restraint or seclusion as a surrogate marker for effectiveness, and rate of adverse events for safety. Results A total of 191 patients were included in the final analysis. There were 1238 doses of 1-time or PRN medication administered for agitation during the study period. Antipsychotics were administered most frequently (661, 53.4%). However, the most commonly administered medications were diphenhydramine (327, 26.4%), lorazepam (235, 19%), and olanzapine (224, 18.1%). Antipsychotic-induced extrapyramidal symptoms (EPS) occurred in 3 instances (0.24%), with all being managed with diphenhydramine. Discussion When treating agitation in pediatric and adolescent patients admitted to an inpatient behavioral health unit, antipsychotics were administered most frequently. It appears that most doses were well tolerated, except for EPS in a subset of patients.
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Yang, M., Rarrick, C., Ross, C. (2026). Pharmacotherapy for pediatric and adolescent agitation in an inpatient behavioral health unit. Mental Health Clinician. https://doi.org/10.9740/mhc.2026.06.135