The agitated patient

The emergency management of the agitated patient is a common medical problem. Agitated behavior is not a diagnosis but a descriptive term; the initial task of the physician involves determining the etiology of the behavioral disturbance and evaluating the possible contribution of organic factors. Such factors as age of onset, acuteness of onset, concurrent illness, evidence of delirium or dementia, or use of exogenous pharmacologic agents require careful evaluation. Agitated patients will generally fall into one of four diagnostic categories: agitation precipitated by drug intoxication, agitation precipitated by drug withdrawal, agitation precipitated by an organic brain syndrome, or agitation precipitated by a functional disorder. Appropriate pharmacological and psychological management techniques for these situations are discussed.