Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.
Agitation can come on suddenly or over time. It can last for a few minutes, for weeks, or even months. Pain, stress, and fever can all increase agitation.
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article
Agitation by itself may not be a sign of a health problem. But if other symptoms occur, it can be a sign of disease.
Agitation with a change in alertness (altered consciousness) can be a sign of delirium. Delirium has a medical cause and should be checked by a health care provider right away.
Delirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.Read Article Now Book Mark Article
There are many causes of agitation. Some of them are:
- Alcohol intoxication or withdrawal
Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article
- Allergic reaction
- Caffeine intoxication
- Certain forms of heart, lung, liver, or kidney disease
- Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiods)
- Hospitalization (older adults often have delirium while in the hospital)
Overactive thyroid gland (hyperthyroidism)
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.Read Article Now Book Mark Article
- Infection (especially in elderly people)
The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine.Read Article Now Book Mark Article
- Poisoning (for example, carbon monoxide poisoning)
- Some medicines, including theophylline, amphetamines, and steroids
Vitamin B6 deficiency
Vitamin B6 is a water-soluble vitamin. Water-soluble vitamins dissolve in water so the body cannot store them. Leftover amounts of the vitamin leav...Read Article Now Book Mark Article
Agitation can occur with brain and mental health disorders, such as:
- Dementia (such as Alzheimer disease)
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer disease (AD) is the most common form of dementia. It affects memo...Read Article Now Book Mark Article
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article
Schizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearl...Read Article Now Book Mark Article
The most important way to deal with agitation is to find and treat the cause. Agitation may lead to an increased risk of suicide and other forms of violence.
Suicide is the act of taking one's own life on purpose. Suicidal behavior is any action that could cause a person to die, such as taking a drug over...Read Article Now Book Mark Article
After treating the cause, the following measures can reduce agitation:
- A calm environment
- Enough lighting during the day and darkness at night
- Medicines such as benzodiazepines, and in some cases, antipsychotics
- Plenty of sleep
DO NOT physically hold back an agitated person, if possible. This usually makes the problem worse. Use restraints only if the person is at risk of harming themselves or others, and there is no other way to control the behavior.
When to Contact a Medical Professional
Contact your provider for agitation that:
- Lasts a long time
- Is very severe
- Occurs with thoughts or actions of hurting yourself or others
- Occurs with other, unexplained symptoms
If you are thinking about hurting yourself or others, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
What to Expect at Your Office Visit
Your provider will take a medical history and do a physical examination. To better understand your agitation, your provider may ask you specific things about your agitation.
Tests may include:
- Blood tests (such as a blood count, infection screening, thyroid tests, or vitamin levels)
Head CT or head MRI scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.Read Article Now Book Mark Article
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...Read Article Now Book Mark Article
Lumbar puncture (spinal tap)
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...Read Article Now Book Mark Article
- Urine tests (for infection screening, drug screening)
Vital signs (temperature, pulse, breathing rate, blood pressure)
Vital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...Read Article Now Book Mark Article
The pulse is the number of heartbeats per minute.Read Article Now Book Mark Article
Treatment depends on the cause of your agitation.
American Psychiatric Association website. Schizophrenia spectrum and other psychotic disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:87-122.
Inouye SK. Delirium in the older patient. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 25.
Prager LM, Ivkovic A. Emergency psychiatry. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 88.
Review Date: 4/30/2022
Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.