A violent manic patient should not be treated with:
(Ref: Goodman & Gillman 13th ed. P 281-282)* For acute manic attacks, preferred agents are atypical antipsychotics, benzodiazepines, anticonvulsants (Valproate, carbamazepine), Lithium* All atypical antipsychotics medications with the exception of clozapine, iloperidone, brexpiprazole, and lurasidone, have indications for acute mania, and doses are titrated rapidly close to or at the maximum FDA- approved dose over the first 24-72 hours of treatment. Typical antipsychotic drugs are also effective in acute mania, but often are eschewed due to the risk for EPSs.
Benzodiazepines
Cognitive therapy
Atypical antipsychotics
Quetiapine
C.N.S