Alternative Names: Restlessness

Considerations:

Extreme agitation can lead to confusion, hyperactivity, and outright hostility. Agitation can come on suddenly or gradually. It can last for just a few minutes or for weeks and even months. Pain, stress, and fever can all increase agitation.

Agitation by itself may not have much clinical significance; but, if viewed with other symptoms, it can be a good indicator of a disease state.

Common Causes:

• alcohol withdrawal
• nicotine withdrawal
• cocaine withdrawal
• opiate withdrawal
• caffeine
• cocaine, hallucinogenic drugs, ephedrine
• theophylline or other medicines
• vitamin B-6 deficiency
• hyperthyroidism
• medical tests that involve injecting a "contrast medium" into the patient

Agitation can be associated with anxiety and depression, bipolar disorder, and schizophrenia.

Home Care:

A calm environment, plenty of sleep, adequate lighting, and any measure to reduce stress may help to decrease agitation. Avoid restraining an overly-agitated person if possible, since this usually makes the problem worse.

Communication of feelings is important.

Call your health care provider if:

• there is prolonged or severe agitation, especially if accompanied by other unexplained symptoms.

What to expect at your health care provider's office:

Your health care provider will obtain a medical history from either the patient or a family member and do a physical examination.

To help better understand your agitation, your doctor may ask the following:

• type
  • Is the patient more talkative than usual or is there a feeling of pressure to keep talking?
  • Does the patient show increased purposeless activity (e.g., pacing, hand wringing)?
  • Is the patient extremely restless?
  • Is the patient trembling or twitching?
• time pattern
  • Was the agitation a short episode?
  • Is the agitation persistent?
    • How long did it persist -- for how many day(s)?
• aggravating factors
  • Does the agitation seem to be triggered by reminders of a traumatic event?
  • Did you notice anything else that may have triggered agitation?
  • Does the patient take any medications, in particular, steroids or thyroid medicine?
  • How much alcohol does the patient drink?
  • How much caffeine does the patient drink?
  • Does the patient use any drugs, in particular, cocaine, narcotics, or amphetamines (speed)?
• other
  • What other symptoms are also present?
  • Is there confusion, memory loss, hyperactivity, or hostility (these symptoms may play an important role in diagnosis).

Diagnostic tests may include:

• Vital signs (temperature, pulse, rate of breathing, blood pressure)
• Blood studies (such as CBC, blood differential, thyroid studies, drug screening)
• Head CT scan or cranial MRI (head)
• Lumbar puncture
• X-rays of the skull