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)

Neuroleptics are employed in the treatment of psychotic states but also in the treatment of anxiety states, as anti-emetics, in the treatment of pain and for anaesthesia. In approximately 20% of the patients, side effect in the form of akathisia are observed. Akathisia caused by neuroleptics may be difficult to diagnose as the symptoms are non-specific with anxiety, restlessness and agitation. Treatment consisted previously of anticholinergics but investigations have been published which demonstrate good effects of non-specifically acting beta-receptor blocking agents. On the basis of a review of the literature, the development of akathisia caused by neuroleptics is described, the symptoms and differential diagnoses involved and the therapeutic possibilities, are described.
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PMID:[Akathisia. A frequent adverse effect in treatment with neuroleptics]. 167 6

Agitation and other noncognitive abnormalities in patients with Alzheimer's disease are present in at least 50% of patients and are a serious problem for caregivers. Agitation can be divided into aggressive agitation, physically nonaggressive agitation, and verbal agitation. Persecutory delusions of suspiciousness and stealing are the most common psychotic symptoms. Auditory and visual hallucinations are also associated with delusions. Similar to delusions are misidentifications, which are false beliefs probably secondary to agnosia. They occur in one third of patients with dementia of the Alzheimer type in the form of the belief that strangers are living in the home and misidentification of the patient's home and reflection in the mirror. Passive personality changes are present early in the disease, whereas agitation and psychotic symptoms occur with disease progression and predict a more rapid rate of cognitive decline. Agitation and wandering are related to more severe cognitive impairment and psychosocial variables, and neurochemical variables that may be related to behavior disturbance require further study. There are few systematic studies of behavioral or environmental interventions for behavioral symptoms in patients with Alzheimer's disease. Current treatment emphasizes education of families, the formation of Alzheimer units in the nursing home, and adjunctive psychotropic agents to treat well-defined target symptoms.
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PMID:Agitation and other noncognitive abnormalities in Alzheimer's disease. 167 6

All incident cases of clinically diagnosed Alzheimer's disease were identified through the unique record linkage system of the Mayo Clinic. Thirty-nine (32%) of the sample of 122 had a psychiatric history that preceded the onset of CDAD by at least 3 years. Twenty-five percent of the study population had had an episode of delirium within 2 years of the onset of CDAD. Eighty-four percent of the cases had psychiatric symptoms in the course of CDAD that were documented in their medical records. Specific symptom patterns included agitation, combativeness, confusion and disorientation, depression, psychosis, and wandering. These symptoms occurred more frequently in clusters than singularly.
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PMID:Psychiatric symptoms in cases of clinically diagnosed Alzheimer's disease. 185 24

Ever since the introduction of the alkaloid ephedrine as an anti-asthmatic, the CNS stimulatory effects of this sympathomimetic have been a problem in therapy. Indeed, the use of ephedrine is not only limited by its cardiovascular effects, but also by the occurrence of insomnia, restlessness and anxiety. Exceptionally, ephedrine may even induce toxic psychosis, and the possibility of this side effect has recently received renewed attention. Besides ephedrine, the ephedra plant contains some norpseudoephedrine. This substance is also called cathine, because it is a major alkaloid of Catha edulis or khat, a plant that is widely used as a stimulant in certain countries of East Africa and of the Arab Peninsula. The effects of khat have been explained formerly by those of cathine; some time ago, however, the labile alkaloid cathinone was discovered in khat. This substance is the keto-analog of cathine; it is therefore more lipophilic and penetrates easily to its sites of action in the central nervous system. Indeed, cathinone has been found to be a highly potent CNS stimulant and it is now known to be the main psychoactive constituent of khat; the results of various in vitro and in vivo studies indicate that cathinone must be considered a natural amphetamine. In confirmation of this view, it has recently been demonstrated that cathinone has in humans marked euphorigenic and psychostimulant effects. As the case may be, these findings may lead, together with epidemiological data, to a reconsideration of the use of khat as a stimulant and social drug.
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PMID:The pharmacology of psychoactive alkaloids from ephedra and catha. 188 Nov 58

The more common behavioral disturbances associated with dementia in elderly patients include depression, psychosis, and agitation. Diagnosis of the underlying cause of these behavioral disturbances begins with a careful investigation of possible medical or toxic disturbances, followed by a careful diagnostic assessment for co-morbid psychiatric syndromes. Treatment of the psychiatric syndromes is often beneficial to the demented patient, improving functional status and reducing the potential for additional morbidity. Patients receiving psychoactive drugs require close monitoring for side effects.
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PMID:Behavioral problems associated with dementia: diagnosis and treatment. 193 59

The relationship of behavioral disturbances in Alzheimer's disease to disease severity, age at onset, and the presence of extrapyramidal signs was investigated in three studies. Five categories of behavior disturbance were ascertained through structured interview with the patient's primary caregiver: apathy, agitation, psychotic symptoms, disinhibition, and irritability. In Study 1, measures of disease severity accounted for 42% of the variance in the Apathy scale but less than 20% of the variance in the remaining scales. In Study 2, the presence of extrapyramidal signs was associated with increased Apathy and moderated the association between disease severity and the Psychotic Symptoms and Irritability scales. In Study 3, age at onset was associated with the Agitation scale and moderated the association between disease severity and the Apathy, Psychotic Symptoms, and Irritability scales. The findings are discussed in terms of the clinical heterogeneity within Alzheimer's disease, the possible biological bases of these behavioral disturbances, and the psychometric issues pertinent to their measurement.
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PMID:Predictors of behavioral disturbance in Alzheimer's disease. 194 93

1. The authors review the literature describing acute symptomatology produced by the gradual or abrupt withdrawal of heterocyclic antidepressants, monoamine oxidase inhibitors (MAOI) and neuroleptics. 2. Withdrawal of heterocyclic antidepressants and antipsychotic agents causes similar symptomatology. Symptoms produced by the discontinuation of these drugs include nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. 3. Psychotic relapse is often presaged by anxiety, agitation, restlessness, and insomnia. Prodromal symptoms are distinguished from the effects of neuroleptic withdrawal by a temporal relationship of the latter to reductions in the dosage or discontinuation of antipsychotic agents. 4. Withdrawal of MAOIs can result in severe anxiety, agitation, pressured speech, sleeplessness or drowsiness, hallucinations, delirium, and paranoid psychosis. 5. MAOI withdrawal phenomena resemble the symptoms produced by the discontinuation of chronically administered psychostimulants. 6. The capacity of MAOIs to exert amphetamine-like effects presynaptically and the propensity of somatic treatments for depression to subsensitize presynaptic receptors regulating the release of catecholamines provide a basis for the development of psychotic symptoms upon the withdrawal of MAOI. Evidence for this hypothesis is reviewed.
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PMID:Heterocyclic antidepressant, monoamine oxidase inhibitor and neuroleptic withdrawal phenomena. 196 71

The author reviews the role of high-frequency benzodiazepines in the treatment of psychosis. Lorazepam and clonazepam are of established value in controlling acute psychotic agitation and catatonia. These agents have also been shown to be helpful in managing neuroleptic-induced akathisia. Recent data strongly support an adjunctive role for alprazolam in the treatment of neuroleptic-resistant symptoms in a subgroup of chronic schizophrenics. Separate, though overlapping, profiles of clinical efficacy are described for the three currently available agents. Alprazolam is suggested to be useful in depressive psychosis and clonazepam in manic psychosis. Lorazepam is suggested to be without specific "mood-normalizing" effects.
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PMID:Emerging uses for high-potency benzodiazepines in psychotic disorders. 197 Aug 17

Neuroleptics are commonly prescribed medications in the geriatric population and have a broader spectrum of indications than in younger patients. In spite of the frequent use of neuroleptics in elderly patients with organic brain syndromes, there are relatively few studies that use double-blind, placebo-controlled methodology. The results of these studies are conflicting; however, there is sufficient evidence that symptoms of agitation, behaviourial dyscontrol, and psychosis are often responsive to neuroleptic treatment. Elderly patients with schizophrenia or other psychotic disorders may also benefit from neuroleptic treatment. As there is a potential for overuse of these medications among the elderly, clear definition of checklist symptoms is imperative. Furthermore, periodic reduction of dose and possible discontinuation of the drug should be considered since many of the checklist symptoms in this age group are environmentally related and time-limited. There has so far been little evidence to support the use of one neuroleptic over another. Side-effect profiles suggest that low doses of the high potency agents are safer and better tolerated in the elderly. Both therapeutic effects and side effects should be assessed at regular intervals.
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PMID:Antipsychotics in the elderly. 197 79

Drugs may be part of the treatment for Alzheimer's disease. Drug treatment can be divided into two categories: treatment to improve cognitive function and treatment to improve abnormal behaviors. There are at least 16 new drugs undergoing evaluation that may improve cognitive function. Some of these drugs are intended to augment acetylcholine neurotransmitter function. Others are nootropics that affect neuron metabolism with little effect elsewhere. A third major category is drugs that affect brain vasculature. A miscellaneous group includes drugs aimed at modifying other defects found in Alzheimer's disease. Drugs to affect behavior have been available for some time. These include neuroleptics, anxiolytics, and antirage drugs. Use of all these drugs has been controversial. Recent federal legislation and guidelines affect their use in nursing homes. Specific indications for neuroleptics are psychotic features and agitation. Dosage for patients with dementia is different than for other psychotic patients. There is no consensus on the use of other psychoactive medications.
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PMID:Drug treatment of Alzheimer's disease. 199 51


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