Psychomotor Agitation
Psychomotor agitation
Classification and external resources
Specialty Psychiatry, emergency medicine
ICD-9-CM 308.2
MeSH D011595

Psychomotor agitation is a set of symptoms that stem from mental tension and anxiety. Symptoms include unintentional and purposeless motions, emotional distress, and restlessness. In more severe cases, the motions may become harmful to the individual, such as ripping, tearing, or chewing at the skin around one's fingernails.

Psychomotor agitation may occur in major depressive disorder, obsessive-compulsive disorder, the manic phase in bipolar disorder, or as a result of an excess intake of stimulants. It can also be caused by severe hyponatremia. The middle-aged and the elderly are more at risk.

Causes

Causes include:[1]

Treatment

Intramuscular midazolam, lorazepam, or another benzodiazepine can be used to both sedate agitated patients, and control semi-involuntary muscle movements in cases of suspected akathisia.

Droperidol, haloperidol, or other typical antipsychotics can decrease the duration of agitation caused by acute psychosis, but should be avoided if the agitation is suspected to be akathisia, which can be potentially worsened.[3] Also using promethazine may be useful.[4]


In those with psychosis causing agitation there is a lack of support for the use of benzodiazepines, although they can prevent side effects associated with dopamine antagonists.[5]

See also

References

  1. ^ Causes of Psychomotor agitation, Retrieved 11th March 2016.
  2. ^ Koenig, AM; Arnold, SE; Streim, JE (January 2016). "Agitation and Irritability in Alzheimer's Disease: Evidenced-Based Treatments and the Black-Box Warning.". Current psychiatry reports. 18 (1): 3. PMID 26695173. doi:10.1007/s11920-015-0640-7. 
  3. ^ Isbister GK, Calver LA, Page CB, Stokes B, Bryant JL, Downes MA (October 2010). "Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM study". Ann Emerg Med. 56 (4): 392-401.e1. PMID 20868907. doi:10.1016/j.annemergmed.2010.05.037. 
  4. ^ Ostinelli, EG; Brooke-Powney, MJ; Li, X; Adams, CE (31 July 2017). "Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation).". The Cochrane database of systematic reviews. 7: CD009377. PMID 28758203. doi:10.1002/14651858.CD009377.pub3. 
  5. ^ Gillies, D; Sampson, S; Beck, A; Rathbone, J (Apr 30, 2013). "Benzodiazepines for psychosis-induced aggression or agitation.". The Cochrane database of systematic reviews. 4: CD003079. PMID 23633309. doi:10.1002/14651858.CD003079.pub3. 

External links



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