Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adverse reactions to phenothiazines have not been commonly recognized in patients with chronic renal failure. We wish to report a characteristic acute psychosis as a complication of phenothiazine use in such individuals. Four patients with chronic renal failure requiring hemodialysis were given doses of chlorpromazine ranging from 100--1000 mg over time intervals varying from 2--7 days. All developed extreme restlessness, auditory and visual hallucinations, and episodes of belligerent behavior. A fifth patient treated with promethazine developed a similar psychosis. Each became ill shortly after the initiation of phenothiazine therapy. All improved slowly after cessation of the drug. Hemodialysis in four patients did not appear to affect the course of the illness. The use of phenothiazines in patients with chronic renal failure is cautioned.
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PMID:Toxic psychosis induced by phenothiazine administration in patients with chronic renal failure. 72 14

Synthetic salmon calcitonin was administered subcutaneously to 12 inpatients with several primary psychotic diagnoses. Increases in serum total calcium and inorganic phosphorus levels and decreases in CSF calcium level had earlier been observed during periodic psychotic agitation or mania. By contrast, calcitonin, which decreased serum calcium and phosphorus levels and increased CSF calcium level, appeared to produce transient (24-hour) increases in depression and decreases in arousal in this double-blind placebo-controlled trial. Quantitative activity monitoring confirmed the rater's impression that this agent had tranquilizing or depressant effects in such patients. When given in the evening, this polypeptide also appeared to delay sleep onset, as demonstrated both by nurses' 30-minute sleep checks and by the same longitudinal activity record. A decreased hypocalcemic response to calcitonin was noted in the agitated patients, which might explain the increases in serum calcium level described at the "switch".
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PMID:Use of calcitonin in psychotic agitation or mania. 76 Jun 98

Admission thyroid function tests were reviewed in 115 euthyroid patients with depression (66), depression and alcohol abuse (30), or alcohol abuse (19). Estimated free thyroxine (EFT) levels ranged from 0.7 to 2.7 ng/100 ml (normal, 1.0 to 2.1). Levels above 2.1 ng/100 ml were associated with agitation and values under 1.1 with alcohol abuse. Mean EFT levels differed significantly among six diagnostic subgroups and paralleled rank order for severity of depression (none, secondary, reactive, single uncategorized, recurrent, psychotic). Alcohol abuse negatively affected EFT: there was a significant decrease of mean EFT level from nonabusers to abusers and, further, to intoxicated abusers. A positive association between EFT level and severity of depression, and a negative one with alcohol use, were significant when other variables considered were controlled. These two factors accounted from 28.2% of variability in EFT levels, with a minimal additional contribution of medication effect.
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PMID:Thyroid function in depression and alcohol abuse: a retrospective study. 88 24

We reviewed the use of physostigmine in the diagnosis and management of acute toxic psychosis due to drugs with anticholinergic properties. The syndrome of agitation and toxic confusional psychosis associated with peripheral signs of cholinergic blockade is produced by several plant toxins, antispasmodics, ophthalmic preparations, and certain proprietary sedatives, as well as antiparkinson medications, antidepressants, and some antipsychotic drugs. Physostigmine, uniquely among the available reversible anticholinesterase agents, can pass the blood-brain barrier to exert central as well as peripheral cholinomimetic actions to reverse this syndrome. Psychiatrists should make more use of this safe, specific, rapid, and effective treatment for anticholinergic drug toxicity, and should particularly be alert to reversible anticholinergic brain syndromes associated with antidepressants and antiparkinson medications, and even with antipsychotic medications.
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PMID:Physostigmine. Its use in acute anticholinergic syndrome with antidepressant and antiparkinson drugs. 111 77

From a sample of 1,005 patients admitted to the Psychiatric Hospital in Aarhus for the first time during the period 1950-1959 and diagnosed as suffering from manic-depressive psychosis or endogenous depression (affective psychoses), a subsample of 104 manic-depressive patients with anancastic symptoms in the history was selected. The 104 probands were individually matched with 104 non-anancastic probands with affective psychoses. The study was designed as a follow-up study, and the patients who were still living were seen personally. In the search for factors which could be used to distinguish affective psychoses with anancastic symptoms from affective psychoses without these traits, the incidence of a number of psychopathological features was evaluated based on the case histories and the information given by the patients at the follow-up. There was no difference as far as atypical, schizophrenia-like symptoms were concerned between the anancastic probands and the controls. Manic and hypomanic features were more frequent among the controls, corresponding to a greater number of bipolar psychoses among them. At the same time, the controls showed a significant preponderance of decidedly psychotic symptoms such as disturbances of consciousness, delusions and delusion-like ideas and hallucinations. Furthermore, retardation was more frequent among the controls. There was no difference in the suicidal behaviour of the two groups. Symptoms which were more often met among the anancastic depressives were: anxiety, agitation, diurnal variation of mood and early awakening. Seasonal variation in symptomatology was also more frequent among the anancastic probands. The same held true for depersonalization. The anancastic probands showed a significant preponderance of anancastic premorbid personality features. A positive correlation was found between the number of anancastic personality features and the following symptoms: agitation, anxiety, diurnal fluctuation, seasonal variation, hypochondriacal attitude and depersonalization. On the other hand, objective retardation or flight of ideas showed a significant negative correlation. The pattern of the anancastic symptoms was rather uniform; aggressive obsessions, mostly in the form of suicidal and homicidal obsessions, were present in more than two thirds of the cases. The anancastic depressions were often less severe than non-anancastic depressions in that the latter were more often complicated by decidedly psychotic symptoms. It is possible to interpret the symptomatology of anancastic depressions as a pathoplastic influence of the anancastic personality, but it cannot be excluded that some of the symptoms like anxiety and agitation are linked to the presence of anancastic symptoms as such.
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PMID:The psychopathology of anancastic endogenous depression. 119 73

Lumbar cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5HIAA) following probenecid was negatively correlated with prognostic variables in a group of schizophrenic patients. Acute schizophrenic patients had lower CSF 5HIIA was negatively correlated with measured activity and rated agitation in a mixed group of schizophrenic patients. There is compelling evidence that LSD directly inhibits the firing of serotonergic neurons. Individuals who developed prolonged psychotic reactions following LSD ingestion had relatively good premorbid trait histories and a family history of psychosis in 33% of cases compared to 21% for non drug-induced psychotic patients. If central serotonin system in man are mainly inhibitory, our results are consistent with the hypothesis that in some acute psychotic states a primary decreases in sertonergic neuronal activity may contribute to excessive central nervous system arousal.
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PMID:Serotonin (5HT) systems in psychotic states. 122 18

Phencyclidine hydrochloride abuse has become increasingly common and should be considered in patients with unexplained acute psychosis, dystonic reactions, status epilepticus, or coma. Two phencyclidine-intoxicated patients had bizarre combinations or disorientation, hallucination, agitation, and dyskinetic motor activity. Supportive care and reduction of sensory stimulation are the basis for management of the symptoms.
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PMID:Phencyclidine poisoning. 124 70

This report describes a patient with schizophrenia who developed episodes of ocular dystonia as a delayed side effect of neuroleptic medication. Each episode was preceded and accompanied by marked agitation, stereotypic behaviour and exacerbation of hallucinations. Both the psychotic and dystonic symptoms responded to anticholinergic medication. The theoretical and practical implications of this observation are discussed.
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PMID:Psychotic symptoms preceding ocular deviation in a patient with tardive oculogyric crises. 136 53

The seclusion of psychiatric patients is viewed by some as a violation of basic human rights, by others as a necessity for the control of violence, and by still others as a therapeutic modality. The purpose of this paper is to synthesize the findings from the limited and descriptive research on this controversial practice. The major conclusions suggested by the findings are: (1) The reason cited for seclusion is more often agitation than violence, raising questions as to its necessity. The lack of relationship between the reason for seclusion and its duration indicates loose and arbitrary criteria and raises the question of bias. (2) The tendency to seclude on admission suggests failure to follow the legal stipulation that less restrictive measures be employed first. (3) Psychotic, involuntary and younger patients are at higher risk for seclusion than other patients. (4) Incidence and duration of seclusion differ widely across institutions indicating unnecessary and excessive use in some units. Differences may be better explained by hospital factors such as location, staff attitudes and treatment philosophy than by patient characteristics. (5) Systematic studies of the effectiveness of seclusion are lacking, as is research on events transpiring during seclusion. (6) Attitudes of patients and staff toward seclusion differ greatly. Patients' attitudes are generally negative, whereas staff members believe seclusion benefits patients and preserves the unit's smooth functioning. Changes in procedures are suggested to reduce the frequency of seclusion, and to make seclusion more rational, effective and humane. Research and clinical implications are discussed.
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PMID:On the seclusion of psychiatric patients. 143 21

A 64-year-old man developed hallucinations, delusions, and agitation after a right hemispheric cerebrovascular accident (CVA) in the occipital, inferior temporal, and parietal regions of the posterior cerebral artery. A review of the literature suggests that psychotic behavior is rare after CVA, but when such behavior does occur, the lesion is usually in the right hemisphere. Two clinical presentations are seen. One presentation involves patients free of chronic disease who develop episodic psychotic behavior at a time remote from their CVA. Electroencephalogram often demonstrates epileptogenic foci, and these patients often improve with anticonvulsant medication. Another presentation involves patients with one or more chronic diseases, often resulting in brain atrophy, who display continuous abnormal behavior soon after their CVA; these patients respond variably to antipsychotic agents.
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PMID:Psychotic behavior after right hemispheric cerebrovascular accident: a case report. 155 13


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