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)

A middle-aged man, who presented to the emergency room because of bizarre outbursts of laughter, was found to be in partial complex status epilepticus. His seizure disorder had been misdiagnosed, at various times, as a variety of "functional" psychiatric disorders. Despite proper diagnosis and aggressive treatment, management was difficult, being complicated by postictal agitation and confusion, postictal psychosis, and interictal compulsive and paranoid personality features. This case is described, and issues of diagnosis and management in partial complex epilepsy are briefly discussed. The importance of not overlooking organic and especially epileptic factors, despite the presence of prior psychiatric illness, psychologic contributors, and environmental stressors, is emphasized.
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PMID:Complex partial status epilepticus presenting as gelastic seizures: a case report. 394 17

Episodes of depression and acute psychosis in two patients receiving propranolol hydrochloride are described, and the literature on propranolol-induced depression and psychosis is reviewed. A 42-year-old woman developed severe depression, marked apathy, social withdrawal, and anorexia after taking propranolol hydrochloride (80 mg/day) for three months to control her hypertension. Five days after the dose was reduced to 40 mg/day, there was a major improvement in her depressive symptoms, with a complete resolution in eight days. Upon rechallenge with 80 mg/day of propranolol, she again experienced depressive symptoms. Atenolol 50 mg/day was substituted for the propranolol therapy, and she exhibited a complete remission of her depression. The second patient was a 63-year-old man who had been taking propranolol hydrochloride 160 mg/day for three months without incident. Because of an increased frequency of anginal attacks, the dosage was increased to 240 mg/day. Within two days, he demonstrated such agitation, excitement, and combativeness that he had to be controlled with a 25-mg dose of methotrimeprazine. When the propranolol dose was reduced to 160 mg/day, his psychotic symptoms rapidly cleared. However, when the dose was subsequently increased to 200 mg/day, he again showed increased agitation. After substituting atenolol 100 mg/day for propranolol, the patient's mental status returned to normal. Both of these patients experienced symptoms that were temporarily associated with propranolol. Both patients were subsequently controlled without symptoms with atenolol therapy. Propranolol is a highly lipophilic beta blocker that achieves high concentrations in the brain. When continued beta-blocking therapy is necessary or beta blockade is indicated, a weakly lipophilic agent such as atenolol is indicated.
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PMID:Propranolol-induced depression and psychosis. 398 22

Five right-handed patients (aged 45 to 78 years) developed acute psychotic disturbances in conjunction with infarcts in the right hemisphere. Their presentation was marked by agitation, inattention, suspiciousness, paranoid delusions, hallucinations, and lack of appropriate concern. Several of these patients initially received primary psychiatric diagnoses. Although neurological findings indicative of right hemisphere involvement could also be elicited, these were generally overshadowed by the more dramatic behavioral alterations. The electroencephalogram and computerized axial tomography were positive in most cases. These cases demonstrate that the possibility of a right hemisphere lesion needs to be entertained in patients who present with an atypical psychotic episode.
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PMID:Psychiatric manifestations of right hemisphere infarctions. 403 38

A program of sociotherapeutic and psychopharmacological treatment of discharged schizophrenic patients is described. An important aspect of the aftercare program is the use of volunteers recruited from the community. The volunteers participate in an educational program, in which they meet schizophrenic patients and receive information about the symptomatology and treatment of psychosis. As a result of this program, many lasting relationships are formed between patients and volunteers. In addition to such sociotherapeutic approaches, discharged patients also require a systematic program of pharmacotherapy. Particular emphasis is placed on the dosage and application intervals of long-term neuroleptics. A handwriting test developed by the author is used to establish the neuroleptic threshold--i.e., the minimum dose a patient needs to compensate psychotic agitation and yet to avoid the sedative major tranquilizer effect.
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PMID:Followup treatment and aftercare of discharged schizophrenic patients. 610 9

In a placebo-controlled double-blind crossover study lithium carbonate was added to the neuroleptic treatment of 11 chronic schizophrenic and 7 schizoaffective inpatients. Nurses' ratings of behavior indicated significant improvement in 8 patients in agitation or manic behavior, 5 patients in psychosis, and 5 patients in depression. A greater initial severity of symptoms, presence of affective symptoms and episodic course characterized the favorable response group. No neurotoxicity was encountered in this study.
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PMID:Lithium combined with neuroleptics in chronic schizophrenic and schizoaffective patients. 611 Jun 54

This paper presents the usage of psychotropic drugs by all general inpatients of a Boston teaching and referral hospital on a randomly chosen weekday. Of all surveyed inpatients, 42.8% were receiving at least one psychotropic medication. Sleep medications were the most frequently prescribed class of psychotropic drugs and flurazepam was the most commonly prescribed of all drugs. Phenothiazine and neuroleptics were given to control agitation, pain, or nausea, rather than psychosis. Antidepressants were prescribed without notated justification in the medical record, and if given for depression, were underdosed. Diazepam was the most frequently prescribed antianxiety drug and was the most frequently prescribed psychotropic drug after flurazepam. Psychotropic drug polypharmacy was common, with the average patient receiving seven different drugs. Remedial approaches to this widespread problem are recommended.
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PMID:Psychotropic drug use and polypharmacy in a general hospital. 611 14

The short term activity of neuroleptics allows the possibility to distinguish between: 1 - their instictive-affective effects which can, according to the case, either diminish agitation, vigilance, aggressivity, anxiety and mood, or the disinhibitors in case of anti-autistic action; 2 - their effects reducing hallucinations and delusions. After 6 months, and more, in the case of schizophrenia or other psychotic evolution, the preventive effect on psychotic relapses appears as unquestionable to many psychiatrists even though there do exist discrepancies in controlled studies. A regularly administrated treatment reveals the possibility of a favorable evolution with a restitution of social and hedonic capacities. Indeed, although the patients behave in a neurotic or psychopathic way, there is no indication that they are to shift from their psychotic structure. We think it necessary to find new trends in the biological treatment of psychosis when unpredictable neurological or endocrinal side-effects occur, or when too numerous patients to remain neuroleptic-resistant.
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PMID:[Psychological effects of neuroleptics (author's transl)]. 611 92

The electroconvulsive therapy (ECT) continues to be of use in the management of patients suffering from affective psychosis and some clinical forms of schizophrenia. The use of premedicated anaesthetic and miorelaxant drugs lessens the possibility of complications, but risks the induction of serious cardiorespiratory accidents. The flunitrazepam is a benzodiazepine with hypnotic, ansiolytic and miorelaxant properties, which has been used as an anaesthetic in major and minor surgery. 241 ECT were essayed on 28 psychotic patients and flunitrazepam induced deep sleep in 94.6% of the applications within 0.5 and 15 minutes after the intravenous injection, the required dose oscillating between 2 and 4 mg. In all the applications a generalized convulsive crisis was induced. No significant pulse variations, arterial pressure, nor respiratory frequency took place. Post ECT agitation appeared in 0.82%. The associated pharmacological therapy (neuroleptics, lithium salts) did not modify the effect of flunitrazepam. Nor did tolerancy to the drug appear.
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PMID:[Medication with flunitrazepam in electroconvulsive therapy]. 612 75

The mental state of 20 psychotic men with high urinary cannabinoid levels on admission to a psychiatric hospital was compared with that of 20 matched cannabis-free controls. All patients underwent toxicological analysis to exclude the presence of alcohol and other exogenous agents. Cannabis levels were measured by a semiquantitative enzyme immunological technique and mental state was assessed by the use of the Present State Examination (PSE), once shortly after admission and again 7 days later. The cannabis group showed significantly more hypomania and agitation and significantly less affective flattening, auditory hallucinations, incoherence of speech, and hysteria than did the controls. Clouding of consciousness was absent in most cannabis patients. After 1 week the cannabis group showed marked improvement (particularly in the psychotic syndromes), whereas the controls remained virtually unchanged. There was no significant difference in amount of medication received between the two groups. Our data suggest that a high intake of cannabis may be related to a rapidly resolving psychosis manifesting with marked hypomanic features, though often presenting as a schizophrenia-like illness.
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PMID:Cannabis-associated psychosis with hypomanic features. 612 63

Sultopride, presented in this paper, was tried in five patients with psychomotor agitation and aggressiveness but with a variable underlying structure, from severe neurosis (borderline?) to chronic decompensated psychosis. These manifestations had failed to respond to the other neuroleptics used. Results with sultopride were excellent. This drug deserves a good position among sedative agents with no significant effect on vigilance used in aggressiveness.
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PMID:[Sultopride and agitation]. 629 55


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