Psychomotor agitation - Wikipedia Psychomotor agitation From Wikipedia, the free encyclopedia Jump to navigation Jump to search Spectrum of disorders characterized by unintentional and purposeless motions and restlessness Psychomotor agitation Other names Pacing Specialty Psychiatry, emergency medicine Psychomotor agitation is a spectrum of disorders characterized by unintentional and purposeless motions and restlessness, often accompanied by emotional distress, but not always. Typical manifestations include pacing around a room, wringing the hands, uncontrolled tongue movement, pulling off clothing and putting it back on, and other similar actions. In more severe cases, the motions may become harmful to the individual, such as ripping, tearing, or chewing at the skin around one's fingernails, lips, or other body parts to the point of bleeding. Psychomotor agitation is typically found in major depressive disorder or obsessive-compulsive disorder, and sometimes the manic phase in bipolar disorder, though it can also be a result of an excess intake of stimulants. It can also be caused by severe hyponatremia. The middle-aged and the elderly are more at risk to express it. Contents 1 Signs and symptoms 2 Causes 3 Treatment 4 See also 5 References 6 External links Signs and symptoms[edit] People experiencing psychomotor agitation may feel or do: unable to sit still fidgeting as if their body is stiff unable to relieve tension desperate to find a comfortable position increasingly anxious exasperated tearful extreme irritability, like snapping at friends and family, or being annoyed at small things anger agitation racing thoughts and incessant talking restlessness pacing hand-wringing nail-biting outbursts of complaining or shouting pulling at clothes or hair picking at skin pace around a room tap their fingers tap their feet start and stop tasks abruptly talk very quickly move objects around for no reason take off clothes then put them back on Causes[edit] Causes include:[1] Schizophrenia Bipolar disorder Excited delirium Post-traumatic stress disorder (PTSD) Panic attacks Anxiety disorder Obsessive-compulsive disorder (OCD) Nicotine withdrawal Alcohol withdrawal Opioid Withdrawal Attention-deficit hyperactivity disorder (ADHD) Claustrophobia Dementia Parkinson's disease Traumatic brain injury Alzheimer's disease[2] Acute intermittent porphyria[3][verification needed] Hereditary coproporphyria Variegate porphyria Side effects of drugs like cocaine or methylphenidate Side effects of antipsychotics like haloperidol Major depressive disorder [4] Agitated depression [4] SSRI or SNRI medications As explained in a 2008 study, in people with mood disorders there is a dynamic link between their mood and the way they move.[5] People showing signs of psychomotor agitation may be experiencing mental tension and anxiety, which comes out physically as: fast or repetitive movements movements that have no purpose movements that are not intentional These activities are the subconscious mind's way of trying to relieve tension[citation needed]. Often people experiencing psychomotor agitation feel as if their movements are not deliberate. Sometimes, however, psychomotor agitation does not relate to mental tension and anxiety. Recent studies found that nicotine withdrawal induces psychomotor agitation (motor deficit).[6][7][8][9] In other cases, psychomotor agitation can be caused by antipsychotic medications. For instance, akathisia, a movement disorder sometimes induced by antipsychotics and other psychotropics, is estimated to affect 15-35% of patients with schizophrenia.[10][11] Treatment[edit] Intramuscular midazolam, lorazepam, or another benzodiazepine can be used to both sedate agitated patients, and control semi-involuntary muscle movements in cases of suspected akathisia. Droperidol, haloperidol, or other typical antipsychotics can decrease the duration of agitation caused by acute psychosis, but should be avoided if the agitation is suspected to be akathisia, which can be potentially worsened.[12] Also using promethazine may be useful.[13] Recently, three atypical antipsychotics, olanzapine, aripiprazole and ziprasidone, have become available and FDA approved as an instant release intramuscular injection formulations to control acute agitation. The IM formulations of these three atypical antipsychotics are considered to be at least as effective or even more effective than the IM administration of haloperidol alone or haloperidol with lorazepam[14][15][16] (which is the standard treatment of agitation in most hospitals) and the atypicals have a dramatically improved tolerability due to a milder side-effect profile. In those with psychosis causing agitation there is a lack of support for the use of benzodiazepines alone, however they are commonly used in combination with antipsychotics since they can prevent side effects associated with dopamine antagonists.[17] Also, introducing the following lifestyle changes to their routine may help a person to reduce their anxiety levels:[5] regular exercise yoga and meditation deep breathing exercises See also[edit] Agitation (dementia) Akathisia Body-focused repetitive behavior Excited delirium References[edit] ^ Causes of Psychomotor agitation Archived 2016-03-11 at the Wayback Machine, Retrieved 11 March 2016. ^ Koenig AM, Arnold SE, Streim JE (January 2016). "Agitation and Irritability in Alzheimer's Disease: Evidenced-Based Treatments and the Black-Box Warning". Current Psychiatry Reports. 18 (1): 3. doi:10.1007/s11920-015-0640-7. PMC 6483820. PMID 26695173. ^ "Acute Intermittent Porphyria (AIP)". American Porphyria Foundation. 18 February 2009. Archived from the original on 2 October 2015. Retrieved 8 December 2017. ^ a b "Agitated Depression: Symptoms, Treatment, and Outlook". Healthline. Retrieved 31 July 2018. ^ a b "What is psychomotor agitation?". Medical News Today. ^ Hughes JR (2007). "Effects of abstinence from tobacco: valid symptoms and time course". Nicotine Tob Res. 9 (3): 315–327. doi:10.1080/14622200701188919. PMID 17365764. ^ Grundey J, et al. (2017). "Diverging effects of nicotine on motor learning performance: Improvement in deprived smokers and attenuation in non-smokers". Addict. Behav. 74: 90–97. doi:10.1016/j.addbeh.2017.05.017. PMID 28600927. ^ Becker JA, Kieffer BL, Le Merrer J (2017). "Differential behavioral and molecular alterations upon protracted abstinence from cocaine versus morphine, nicotine, THC and alcohol". Addiction Biology. 22 (5): 1205–1217. doi:10.1111/adb.12405. PMC 5085894. PMID 27126842. ^ Kim B, Im HI (2020). "Chronic nicotine impairs sparse motor learning via striatal fast‐spiking parvalbumin interneurons". Addiction Biology. Early View: e12956. doi:10.1111/adb.12956. PMID 32767546. ^ Berna F, Misdrahi D, Boyer L, Aouizerate B, Brunel L, Capdevielle D, et al. (December 2015). "Akathisia: prevalence and risk factors in a community-dwelling sample of patients with schizophrenia. Results from the FACE-SZ dataset". Schizophrenia Research. 169 (1–3): 255–261. doi:10.1016/j.schres.2015.10.040. PMID 26589388. S2CID 26752064. ^ Salem H, Nagpal C, Pigott T, Teixeira AL (15 June 2017). "Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges". Current Neuropharmacology. 15 (5): 789–798. doi:10.2174/1570159X14666161208153644. PMC 5771055. PMID 27928948. ^ Isbister GK, Calver LA, Page CB, Stokes B, Bryant JL, Downes MA (October 2010). "Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM study". Annals of Emergency Medicine. 56 (4): 392–401.e1. doi:10.1016/j.annemergmed.2010.05.037. PMID 20868907. ^ Ostinelli EG, Brooke-Powney MJ, Li X, Adams CE (July 2017). "Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation)". The Cochrane Database of Systematic Reviews. 7: CD009377. doi:10.1002/14651858.CD009377.pub3. PMC 6483410. PMID 28758203. ^ Huang CL, Hwang TJ, Chen YH, Huang GH, Hsieh MH, Chen HH, Hwu HG (May 2015). "Intramuscular olanzapine versus intramuscular haloperidol plus lorazepam for the treatment of acute schizophrenia with agitation: An open-label, randomized controlled trial". Journal of the Formosan Medical Association = Taiwan Yi Zhi. 114 (5): 438–45. doi:10.1016/j.jfma.2015.01.018. PMID 25791540. ^ Citrome L, Brook S, Warrington L, Loebel A, Mandel FS (October 2004). "Ziprasidone versus haloperidol for the treatment of agitation". Annals of Emergency Medicine. 44 (4): S22. doi:10.1016/j.annemergmed.2004.07.073. ^ Cañas F (March 2007). "Management of agitation in the acute psychotic patient--efficacy without excessive sedation". European Neuropsychopharmacology. 17 Suppl 2: S108-14. doi:10.1016/j.euroneuro.2007.02.004. PMID 17336765. S2CID 14534413. ^ Gillies D, Sampson S, Beck A, Rathbone J (April 2013). "Benzodiazepines for psychosis-induced aggression or agitation". The Cochrane Database of Systematic Reviews. 4 (4): CD003079. doi:10.1002/14651858.CD003079.pub3. hdl:10454/16512. PMID 23633309. External links[edit] Classification D ICD-9-CM: 308.2 MeSH: D011595 v t e Mental and behavioral disorders Adult personality and behavior Gender dysphoria Ego-dystonic sexual orientation Paraphilia Fetishism Voyeurism Sexual maturation disorder Sexual relationship disorder Other Factitious disorder Munchausen syndrome Intermittent explosive disorder Dermatillomania Kleptomania Pyromania Trichotillomania Personality disorder Childhood and learning Emotional and behavioral ADHD Conduct disorder ODD Emotional and behavioral disorders Separation anxiety disorder Movement disorders Stereotypic Social functioning DAD RAD Selective mutism Speech Stuttering Cluttering Tic disorder Tourette syndrome Intellectual disability X-linked intellectual disability Lujan–Fryns syndrome Psychological development (developmental disabilities) Pervasive Specific Mood (affective) Bipolar Bipolar I Bipolar II Bipolar NOS Cyclothymia Depression Atypical depression Dysthymia Major depressive disorder Melancholic depression Seasonal affective disorder Mania Neurological and symptomatic Autism spectrum Autism Asperger syndrome High-functioning autism PDD-NOS Savant syndrome Dementia AIDS dementia complex Alzheimer's disease Creutzfeldt–Jakob disease Frontotemporal dementia Huntington's disease Mild cognitive impairment Parkinson's disease Pick's disease Sundowning Vascular dementia Wandering Other Delirium Organic brain syndrome Post-concussion syndrome Neurotic, stress-related and somatoform Adjustment Adjustment disorder with depressed mood Anxiety Phobia Agoraphobia Social anxiety Social phobia Anthropophobia Specific social phobia Specific phobia Claustrophobia Other Generalized anxiety disorder OCD Panic attack Panic disorder Stress Acute stress reaction PTSD Dissociative Depersonalization disorder Dissociative identity disorder Fugue state Psychogenic amnesia Somatic symptom Body dysmorphic disorder Conversion disorder Ganser syndrome Globus pharyngis Psychogenic non-epileptic seizures False pregnancy Hypochondriasis Mass psychogenic illness Nosophobia Psychogenic pain Somatization disorder Physiological and physical behavior Eating Anorexia nervosa Bulimia nervosa Rumination syndrome Other specified feeding or eating disorder Nonorganic sleep Hypersomnia Insomnia Parasomnia Night terror Nightmare REM sleep behavior disorder Postnatal Postpartum depression Postpartum psychosis Sexual dysfunction Arousal Erectile dysfunction Female sexual arousal disorder Desire Hypersexuality Hypoactive sexual desire disorder Orgasm Anorgasmia Delayed ejaculation Premature ejaculation Sexual anhedonia Pain Nonorganic dyspareunia Nonorganic vaginismus Psychoactive substances, substance abuse and substance-related Drug overdose Intoxication Physical dependence Rebound effect Stimulant psychosis Substance dependence Withdrawal Schizophrenia, schizotypal and delusional Delusional Delusional disorder Folie à deux Psychosis and schizophrenia-like Brief reactive psychosis Schizoaffective disorder Schizophreniform disorder Schizophrenia Childhood schizophrenia Disorganized (hebephrenic) schizophrenia Paranoid schizophrenia Pseudoneurotic schizophrenia Simple-type schizophrenia Other Catatonia Symptoms and uncategorized Impulse control disorder Klüver–Bucy syndrome Psychomotor agitation Stereotypy v t e Diseases of the nervous system, primarily CNS Inflammation Brain Encephalitis Viral encephalitis Herpesviral encephalitis Limbic encephalitis Encephalitis lethargica Cavernous sinus thrombosis Brain abscess Amoebic Brain and spinal cord Encephalomyelitis Acute disseminated Meningitis Meningoencephalitis Brain/ encephalopathy Degenerative Extrapyramidal and movement disorders Basal ganglia disease Parkinsonism PD Postencephalitic NMS PKAN Tauopathy PSP Striatonigral degeneration Hemiballismus HD OA Dyskinesia Dystonia Status dystonicus Spasmodic torticollis Meige's Blepharospasm Athetosis Chorea Choreoathetosis Myoclonus Myoclonic epilepsy Akathisia Tremor Essential tremor Intention tremor Restless legs Stiff-person Dementia Tauopathy Alzheimer's Early-onset Primary progressive aphasia Frontotemporal dementia/Frontotemporal lobar degeneration Pick's Dementia with Lewy bodies Posterior cortical atrophy Vascular dementia Mitochondrial disease Leigh syndrome Demyelinating Autoimmune Inflammatory Multiple sclerosis For more detailed coverage, see Template:Demyelinating diseases of CNS Episodic/ paroxysmal Seizures and epilepsy Focal Generalised Status epilepticus For more detailed coverage, see Template:Epilepsy Headache Migraine Cluster Tension For more detailed coverage, see Template:Headache Cerebrovascular TIA Stroke For more detailed coverage, see Template:Cerebrovascular diseases Other Sleep disorders For more detailed coverage, see Template:Sleep CSF Intracranial hypertension Hydrocephalus Normal pressure hydrocephalus Choroid plexus papilloma Idiopathic intracranial hypertension Cerebral edema Intracranial hypotension Other Brain herniation Reye syndrome Hepatic encephalopathy Toxic encephalopathy Hashimoto's encephalopathy Both/either Degenerative SA Friedreich's ataxia Ataxia–telangiectasia MND UMN only: Primary lateral sclerosis Pseudobulbar palsy Hereditary spastic paraplegia LMN only: Distal hereditary motor neuronopathies Spinal muscular atrophies SMA SMAX1 SMAX2 DSMA1 Congenital DSMA Spinal muscular atrophy with lower extremity predominance (SMALED) SMALED1 SMALED2A SMALED2B SMA-PCH SMA-PME Progressive muscular atrophy Progressive bulbar palsy Fazio–Londe Infantile progressive bulbar palsy both: Amyotrophic lateral sclerosis v t e Emotions (list) Emotions Acceptance Adoration Aesthetic emotions Affection Agitation Agony Amusement Anger Angst Anguish Annoyance Anticipation Anxiety Apathy Arousal Attraction Awe Boredom Calmness Compassion Confidence Contempt Contentment Courage Cruelty Curiosity Defeat Depression Desire Despair Disappointment Disgust Distrust Ecstasy Embarrassment Vicarious Empathy Enthrallment Enthusiasm Envy Euphoria Excitement Fear Flow (psychology) Frustration Gratification Gratitude Greed Grief Guilt Happiness Hatred Hiraeth Homesickness Hope Horror Hostility Humiliation Hygge Hysteria Indulgence Infatuation Insecurity Inspiration Interest Irritation Isolation Jealousy Joy Kindness Loneliness Longing Love Limerence Lust Mono no aware Neglect Nostalgia Outrage Panic Passion Pity Self-pity Pleasure Pride Grandiosity Hubris Insult Vanity Rage Regret Social connection Rejection Remorse Resentment Sadness Melancholy Saudade Schadenfreude Sehnsucht Self-confidence Sentimentality Shame Shock Shyness Sorrow Spite Stress Suffering Surprise Sympathy Tenseness Trust Wonder Worry World views Cynicism Defeatism Nihilism Optimism Pessimism Reclusion Weltschmerz Related Affect consciousness in education measures in psychology Affective computing forecasting neuroscience science spectrum Affectivity positive negative Appeal to emotion Emotion and art and memory and music and sex classification evolution expressed functional accounts group homeostatic perception recognition in conversation in animals regulation interpersonal work Emotional aperture bias blackmail competence conflict contagion detachment dysregulation eating exhaustion expression intelligence and bullying intimacy isolation lability labor lateralization literacy prosody reasoning responsivity security selection symbiosis well-being Emotionality bounded Emotions and culture in decision-making in the workplace in virtual communication history moral self-conscious social social sharing sociology Feeling Gender and emotional expression Group affective tone Interactions between the emotional and executive brain systems Meta-emotion Pathognomy Pathos Social emotional development Stoic passions Theory affect appraisal discrete emotion somatic marker constructed emotion Retrieved from "https://en.wikipedia.org/w/index.php?title=Psychomotor_agitation&oldid=988504706" Categories: Abnormal psychology Hidden categories: Webarchive template wayback links CS1: long volume value Articles with short description Short description is different from Wikidata Use dmy dates from April 2019 All pages needing factual verification Wikipedia articles needing factual verification from January 2017 All articles with unsourced statements Articles with unsourced statements from December 2018 Navigation menu Personal tools Not logged in Talk Contributions Create account Log in Namespaces Article Talk Variants Views Read Edit View history More Search Navigation Main page Contents Current events Random article About Wikipedia Contact us Donate Contribute Help Learn to edit Community portal Recent changes Upload file Tools What links here Related changes Upload file Special pages Permanent link Page information Cite this page Wikidata item Print/export Download as PDF Printable version Languages العربية Беларуская Беларуская (тарашкевіца)‎ Български Deutsch Español فارسی Français עברית Қазақша Македонски Oʻzbekcha/ўзбекча Polski Português Русский Suomi Svenska Türkçe Українська Tiếng Việt Edit links This page was last edited on 13 November 2020, at 16:14 (UTC). Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. Privacy policy About Wikipedia Disclaimers Contact Wikipedia Mobile view Developers Statistics Cookie statement