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Agitation

Definition

Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.

Alternative Names

Restlessness

Considerations

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks or even months. Pain, stress, and fever can all increase agitation.

Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it can be a sign of disease.

Agitation  with a change in alertness (altered consciousness) can be a sign of delirium . Delirium has a medical cause and should be checked by a health care provider right away.

Common Causes

There are many causes of agitation, some of which include:

  • Alcohol intoxication or withdrawal
  • Allergic reaction
  • Caffeine intoxication
  • Certain forms of heart, lung, liver, or kidney disease
  • Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiates)
  • Hospitalization (older adults often have delirium while in the hospital)
  • (overactive thyroid gland)Hyperthyroidism
  • Infection (especially in elderly people)
  • Nicotine withdrawal
  • Poisoning (for example, carbon monoxide poisoning)
  • Theophylline, amphetamines, steroids, and certain other medicines
  • Trauma
  • deficiencyVitamin B6

Agitation can occur with brain and mental health disorders, such as:

Home Care

The most important way to deal with agitation is to find and treat the cause. Agitation may lead to an increased risk of suicide and other forms of violence.

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

  • A calm environment
  • Enough lighting during the day and darkness at night
  • Medications such as benzodiazepines, and in some cases, antipsychotics
  • Plenty of sleep

Don't physically hold back an 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 way to control the behavior.

Call your health care provider if

Contact your health care provider for agitation that:

  • Lasts a long time
  • Is very severe
  • Occurs with thoughts or actions of hurting oneself or others
  • Occurs with other, unexplained symptoms

What to expect at your health care provider's office

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

To help better understand your agitation, your health care provider may ask the following questions:

  • Type
  • Time pattern
  • Factors that make it worse
  • Other

Tests may include:

  • Blood studies (such as a blood count, infection screening, thyroid tests, or vitamin levels)
  • or Head CT scanhead MRI
  • (spinal tap)Lumbar puncture
  • Urine tests (for infection screening, drug screening)
  • (temperature, Vital signs , breathing rate, blood pressure) pulse

References

Park JM, Park L, Prager LM. Emergency psychiatry. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. . 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 87.

Rossi J, Swan MC, Isaacs ED. The violent or agitated patient. . 2010;28:235-256.

Inouye SK. Delirium or acute mental status change in the older patient. In: Goldman L, Schafer AI, eds. . 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 27.

Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.