Agitation and aggression

Both typical and atypical antipsychotics are effective in approximately 70% of patients with acute mania associated with agitation, aggression, and psychosis, and atypical antipsychotics are better tolerated. 

Moclobemide Moclobemide overdose causes adverse effects such as agitation, aggression, and behavioral changes.139... 

The goals during the first 7 days are decreased agitation, hostility, anxiety, and aggression and normalization of sleep and eating patterns. 

Treatment is infrequently required. Severe agitation, anxiety, and aggressive behavior respond to diazepam, for example. Rest in a dark, quiet room is suffieient for the majority of the cases. 

As early as the 1940s it became clear that amphetamine could also produce a calming effect in adults prone to aggression and agitation. Later, this so-called paradoxical effect was also seen in children with hyperkinetic syndrome, the precursor to ADHD. 

Serotonin-Boosting Antidepressants. Antidepressants that enhance serotonin activity in the brain have also been studied in ADHD. In particular, fluoxetine (Prozac) and the serotonin-selective TCA clomipramine (Anafranil) have been the most extensively evaluated, with mixed success. They provide some benefit for aggression and impulsivity but don t significantly improve the poor attention of ADHD. As a result, the SSRls and other serotonin-boosting antidepressants do not appear to be effective first-line treatments for ADHD. Conversely, depressed patients without ADHD often show improvements in symptoms of concentration and attention when treated with a SSRI. Although SSRls are not widely used in the treatment of ADHD, they may be worthy of consideration in ADHD patients whose impulsivity is not controlled by stimulants alone. Those with comorbid conduct disorder or ODD who are prone to agitation and at times violent outbursts may be helped by the addition of a SSRI. 

Indications include a wide variety of psychiatric disorders, in the first place schizophrenia, organic psychoses and other acute psychotic illnesses. However they are also of use for the manic phase of bipolar affective disorder and for psychotic depression. Under antipsychotic drug therapy patients become less agitated and restless, withdrawn and autistic patients may become more communicative, aggressive and impulsive behavior diminishes and hallucinations and disordered thinking disappear. 

A fourth and final part. Other Areas of Clinical Concern, addresses the pharmacological management of aggressive or agitated children, and those with the elimination disorders enuresis or encopresis. 

Sedation They produce sedation which does not progress to anaesthesia. They decrease the agitation, anxiety and aggressiveness in psychotic patient without affecting wakefulness. 

The most serious side effects of efavirenz are psychiatric symptoms, rash and nervous symptoms. The psychiatric symptoms include suicide thoughts, depression, paranoia, manic disorders and aggressive behavior the rashes include macu-lopapular skin eruptions and life-threatening Stevens-Johnson syndrome has also been reported. The neurological symptoms are difficulty in concentration, insomnia, dizziness, confusion, agitation, hallucinations and amnesia. Additional side effect may include an increase in cholesterol and hepatic transaminase levels. 

Incidental and accidental intake of atropine and scopolamine, which are the main tropane alkaloids in plants of the solanecae family, may provoke poisoning of man and livestock [11,13-15, 55, 57,119-122] causing agitation, aggression, hallucinations, dry mouth and skin, mydriasis, loss of consciousness followed by coma combined with tachycardia, hypotension, and hyperthermia [57, 121], A detailed statistical analysis of paediatric plant exposures in Germany within the years 1998-2004 has been provided by Pietsch et al. [123], They found that most prevalent victims of accidental plant exposures are children in the age of 1-6 years presumably being misled by the attractive plump berries. 

---