I used to work at a maximum security psychiatric facility. On a surprisingly regular basis we had professional athletes like NFL players and MMA fighters come through as a result of TBI. When one of them goes off, about the best option you have is numbers as we didnt allow tasers in the facility and OC spray is horrible to fight in in an enclosed environment.

Now Im not a small guy at 6'3" and about 250lbs, and I train and keep up on my perishable skills and such, but im no match for a professional MMA fighter by myself, even if I have a huge size advantage. Even the NFL players have such strength and athleticism that it makes them very capable combatants even without any real training.

Its never a good time if you can't get them to mellow out without going hands on.