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

An outbreak of respiratory tract infection due to influenza A virus occurred in February 1994 among residents of an 88-bed long term care facility in Toronto, Ontario. Eighteen confirmed and four probable cases of influenza were identified for an attack rate of 25%. Seventy-one per cent of the residents were known to have been immunized with trivalent influenza vaccine, but vaccine efficacy was determined to be only 32%. Influenza A viral antigen was rapidly detected by immunofluorescence microscopy of nasopharyngeal swabs, and amantadine hydrochloride was started in 76 residents within 48 h of recognizing the outbreak. Only two of the residents (3%) at risk became ill more than 48 h after amantadine was started. Amantadine was discontinued in four residents (5%) because of adverse effects (agitation, confusion, unsteady gait). In conclusion, rapid identification of the outbreak and prompt administration of amantadine hydrochloride prophylactically appears to be safe and effective in preventing further spread of influenza A.
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PMID:Influenza A outbreak in a nursing home: the value of early diagnosis and the use of amantadine hydrochloride. 776 11

The use of neuroleptics in the acute management of traumatic brain injury (TBI) is controversial and may be detrimental to recovery. The following case report describes a patient developing neuroleptic malignant syndrome (NMS) secondary to the use of haloperidol given to control the patient's agitation. The patient began to exhibit symptoms consistent with NMS (high fever, dystonia, diaphoresis, tachycardia, and decerebrate posturing) shortly after administration of the haloperidol. Upon transfer to a rehabilitation hospital, the symptoms persisted. When NMS is suspected, the first intervention is to remove the offending agent; thus, the administration of haloperidol was suspended, and the patient was placed on Amantadine and propranolol. Amantadine was used to increase the availability of dopamine to the mid-brain region, and the propranolol was used to control the fever, which was believed to be central in origin. The patient was able to complete his rehabilitation with no further incidence of fever or agitation. The patient met or exceeded all short-term physical therapy goals and was able to complete most of the neuropsychological tasks presented. The patient returned home 38 days after admission to the rehabilitation hospital and was able to perform most activities of daily living. At the 6-months follow-up visit, the patient was considering entrance into an adult vocational school.
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PMID:Neuroleptic malignant syndrome induced by haloperidol following traumatic brain injury. 1062 7

There are reports that melatonin secretion from the pineal gland gradually diminishes with advancing age. It has been suggested that various forms of neuropsychiatric disease, in particular, Parkinson's disease (PD), is consequentially related to this decrease by virtue of increased oxidative stress which enhances the process of dopamine (DA) degeneration. There is, however, considerable disagreement on this theme as very little is generally known about the role of the pineal gland in the aetiology and treatment of PD. To assess the role of the pineal gland in PD and in dopamine replacement therapy (DART), the effect of three anti-Parkinsonian drugs on motor and psychiatric function was assessed in normal, pinealectomized (PX) and DA deficient, PX rats. In the first study, rats underwent PX or sham operation and were then injected (IP) with Amantadine (30 or 50 mg/kg), Bromocriptine (5 or 10 mg/kg) or L-Dopa (30 or 60 mg/kg plus 50 mg/kg of R-044602) 3-8 weeks after surgery. Open field performance and motor reflex tests were assessed during the light and dark phases of the L/D cycle. In a second study, clinically effective doses of Bromocriptine (10 mg/kg) and L-Dopa (30 and 100 mg/kg with 50 mg/kg R-044602) were injected into depleted, PX or sham operated rats. In study I, sham operated and PX rats responded differently to Bromocriptine and L-Dopa, while Amantadine did not differentially effect motor performance in the two groups. In study II, 6-OHDA induced degeneration of the nigro-striatal system abolished the effects of Bromocriptine and dramatically altered the effects of L-Dopa seen in study I, in sham operated versus PX rats. DART significantly altered emotionality, as measured by escape attempts, agitation and rage in sham operated animals, compared to PX rats. DA deficiency abolished the tendency to escape in all groups except those treated with 100mg/kg of L-Dopa. Conversely, agitation and rage scores were greater after 100 mg/kg of L-Dopa, in rats with intact pineal function, than in PX rats. These results provide compelling evidence that altered pineal function plays a major role in the aetiology of PD, the therapeutic effect of anti-Parkinsonian drugs and in the psychiatric side effects of DART.
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PMID:The therapeutic effects of dopamine replacement therapy and its psychiatric side effects are mediated by pineal function. 1583 10

Investigation of the pathophysiology of psychosis in Parkinson's disease (PD), as well as the assessment of potential novel therapeutics, has been limited by the lack of a well-validated animal model. MPTP-lesioned primates exhibit abnormal behaviors that are distinct from dyskinesia and parkinsonism and may represent behavioral correlates of neural processes related to psychosis in PD. Here we assess four types of behavior--agitation, hallucinatory-like responses to nonapparent stimuli, obsessive grooming, and stereotypies that are termed "psychosis-like"--and define their pharmacology using a psychosis-like behavior rating scale. By assessing the actions of drugs known to enhance or attenuate psychosis in PD patients, we find that the pharmacology of these behaviors recapitulates, in several respects, the pharmacology of psychosis in PD. Thus, levodopa and apomorphine elicited psychosis-like behaviors. Amantadine significantly decreased levodopa-induced dyskinesia but exacerbated psychosis-like behaviors. Haloperidol reduced psychosis-like behaviors but at the expense of increased parkinsonian disability while the atypical neuroleptics clozapine and quetiapine reduced psychosis-like behaviors without significant effect on parkinsonian disability. The response of different components of the psychotomimetic behavior suggested the involvement of both dopaminergic and nondopaminergic mechanisms in their expression.
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PMID:Pharmacological characterization of psychosis-like behavior in the MPTP-lesioned nonhuman primate model of Parkinson's disease. 1696 Aug 62

Objectives: To systematically review literature on efficacy of amantadine on behavior (irritability/aggression/agitation, emotional lability, apathy, impairment of executive functioning), participation, quality-of-life (QoL), and safety, in patients with acquired brain injury (ABI). Amantadine is widely used clinically, so comprehensive information on efficacy, participation, QoL and safety is relevant. Methods: We used PRISMA Guidelines. We searched PubMed/EMBASE/CINAHL (last search 28-8-2018) Two independent reviewers performed selection and data-extraction. Quality of studies was assessed, using CONSORT and Quality Assessment Tool for Quantitative Studies (QATFQS). Results: Eleven out of 500 studies were included. Of five RCTs, two reported significant effects on irritability/aggression, and one no effect. One RCT on cognition no effect. One prospective cohort study showed a significant effect on executive functioning. One retrospective study was inconclusive. One single-case experimental design (SCED) study reported significant effect on apathy and three case-reports indicated effects on behavior. QoL and societal participation were not measured. No safety issues emerged. Conclusion: Amantadine may be efficacious on irritability and aggression after ABI. Amantadine is a safe drug in the presence of adequate creatinine clearance. Future studies should use designs, suitable for the heterogeneous ABI population, like randomized SCEDs, and should include the effect on societal participation and QoL.
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PMID:Efficacy of amantadine on behavioural problems due to acquired brain injury: A systematic review. 3125 Jun 69