Agitation

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Central nervous system

Restlessness

The most important way to deal with agitation is to find and treat the cause. If left untreated, agitation leads to an increased risk of suicide.

After treating the cause, the following measures can reduce agitation:

• A calm environment
• Adequate lighting
• Medications such as benzodiazepines, and in some cases, antipsychotics
• Plenty of sleep

Don't restrain an overly agitated person, if possible. This usually makes the problem worse. Only use restraints if the person is at risk of harming themselves or others, and there is no other, less restrictive way to control the behavior.

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Contact your health care provider for agitation:

• That lasts for a long period of time
• That is very severe
• If there are other unexplained symptoms

Your health care provider will take a medical history and do a physical examination.

To help better understand your agitation, your doctor may ask the following questions:

• Type
  • Are you more talkative than usual or do you feel pressure to keep talking?
  • Do you find yourself doing purposeless activities (e.g., pacing, hand wringing)?
  • Are you extremely restless?
  • Are you trembling or twitching?
• Time pattern
  • Was the agitation a short episode?
  • Is the agitation persistent?
    • How long did it last -- for how many day(s)?
• Aggravating factors
  • Does the agitation seem to be triggered by reminders of a traumatic event?
  • Did you notice anything else that may have triggered agitation?
  • Do you take any medications, especially steroids or thyroid medicine?
  • How much alcohol do you drink?
  • How much caffeine do you drink?
  • Do you use any drugs, such as cocaine, narcotics, or "speed" (amphetamines)?
• Other
  • What other symptoms do you have?
  • Is there confusion, memory loss, hyperactivity, or hostility (these symptoms can play an important role in diagnosis).

Diagnostic tests may include:

• Blood studies (such as a blood count, infection screening, thyroid tests, or vitamin levels)
• Head CT or head MRI scan
• Lumbar puncture or spinal tap
• Urine tests (infection screening, drug screening)
• Vital signs (temperature, pulse, breathing rate, blood pressure)
• X-rays of the skull

Review Date: 02/28/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Michelle Benger Merrill, MD, Instructor in Clinical Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).