Establishing the effectiveness of various interventions among patients prone to violence and aggression has been limited by ethical constraints. In situations involving acute, frequently unanticipated, events obtaining informed consent for participation is frequently not practical.

Reliance on prospective observational trials has been helpful in a limited number of studies. More of such studies are needed to establish an evidence base for use of many long accepted interventions for treatment of agitation, aggression and violence.

Further studies in special populations such as personality disorders, intellectually disabled, traumatic brain injured and demented patients are needed to assure that benefits of treatment outweigh iatrogenic morbidity and mortality.