Psychomotor agitation - signs, first aid, medication
Many psychoneurological pathologies may be accompanied by a state characterized by hyper mobility and abnormal behavior that does not correspond to the situation. It manifests itself in varying degrees - from the fussy obsessive agitation to uncontrollable aggression. The actions of the patient are often accompanied by a violation of objective perception, hallucinations, delusions and other symptoms, depending on the type of the disease, against which psychomotor agitation develops. A patient of any age in such a state, especially one who is inaccessible to contact, can be dangerous for others and himself, moreover, he will not seek help on his own, since he is unable to control his behavior. Psychomotor agitation involves the development of acute psychosis, therefore, requires the provision of emergency psychiatric care.
Causes of psychomotor agitation
In order to survive this condition, it is not necessary to be a mentally ill person. It can occur as a type of reactive psychosis (psychogenic shock) that a person experiences as a result of very strong emotional turmoil. This could be an event that threatens the life of a person or people very close to him - an accident, a message about an incurable disease, any significant loss, and so on. At risk are people with psychopathic personality traits, paranoid inclinations, emotionally labile, prone to hysteria, accented personalities, whose deviations from the norm are quite compensated and do not reach the pathological level.
In some periods - age crises, pregnancy, a person becomes more vulnerable to the development of psychomotor agitation as a consequence of psychogenic shock. Such cases are usually temporary, sometimes singular, and completely reversible.
The development of psychomotor agitation occurs as a result of brain injuries, infections, complicated by inflammatory diseases of the meninges, intoxication and hypoxia, ischemic processes, hemorrhages and tumors. Psychomotor excitement after a stroke often develops with a hemorrhagic form of a vascular catastrophe, with ischemia, it is also not excluded, but less pronounced.
Psychomotor agitation often develops in individuals with mental disorders (schizophrenia, manic-depressive psychosis, personality disorders), severe mental retardation, or neurological (epilepsy, neuroses) diseases.
The risk factors for the development of this condition are metabolic disorders in the brain tissues as a result of chronic or acute direct intoxication with alcohol, drugs, drugs and other chemicals, pre-comatose and comatose states; autoimmune and immune processes.
The pathogenesis of psychomotor agitation may be different depending on the cause of its development. Psychological features of an individual, circumstances, neuroreflex mechanisms, immunity disorders, ischemic, hemorrhagic, metabolic disorders in the brain substance, direct toxic effects of toxic substances that cause an imbalance of arousal and inhibition are considered as pathogenetic links.
Symptoms of psychomotor agitation
This condition of abnormal hyperactivity is characterized by age. Psychomotor excitement in young children is expressed in monotonous repetitions of shouts, one of a phrase or a question, movements - nodding his head, swaying from side to side, jumping. Children cry mournfully and monotonously, laugh hysterically, make faces, bark or howl, bite their nails.
Older children incessantly move, everyone smashes and tears, sometimes manifestations of aggression are frankly sadistic. They can depict babies - sucking on a finger for a long time, babbling excitedly in a childish way.
Psychomotor excitement in the elderly is also characterized by motor and speech monotony. Manifested by fussiness, anxiety or irritability and grumpiness.
And although the clinical picture of different types of this condition has symptomatic differences (described below), the first signs always appear suddenly and sharply. The patient's behavior draws attention to itself - inadequate movements, violent emotions, defensive reactions, aggressive actions, attempts to injure oneself.
In the mild stage of psychomotor arousal, the patient is unusually mobile, talkative, he is clearly hyperthymic, however, the anomalous behavior is not too noticeable. The middle stage is characterized by already noticeable anomalies, dissociative thinking, unexpected and inadequate actions, the purpose of which is unclear, visible affects (rage, anger, melancholy, unrestrained merriment) and the lack of a critical attitude to their behavior. Acute psychomotor agitation in the third stage is a very dangerous condition that requires emergency medical care. Affects going wild: darkened consciousness, speech and movements are chaotic, may be nonsense, hallucinations. In this state, the patient is inaccessible to contact and is very dangerous for others and himself.
Types of psychomotor arousal largely depend on the reasons that caused it, and differ in clinical course.
Depressive syndromes are characterized by anxiety. Motor reactions in this case are endless monotonous repetitions of simple movements, accompanied by verbal repetitions of the same phrase, words, sometimes just moans. Periodically observed raptus - sudden impulsive attacks, violent cries, self-damaging actions.
Psychogenic arousal occurs on the background of a strong mental shock or under circumstances that pose a threat to life. Accompanying the symptoms of affective-shock disorder: mental and motor over-stimulation, autonomic disorders - increased pulse and respiration, dry mouth, hyperhidrosis, dizziness, tremor of limbs, fear of death. There are various options for symptoms - from catatonic or anxious to senseless panic actions. There may be attempts at suicide, flight from the scene. In global cataclysms and catastrophes, psychogenic arousal is of a group nature.
Psychopathic arousal occurs in people with personality disorders, more often in excitable psychopaths, under the influence of exogenous irritation. In this case, the patient reacts with a force that is absolutely inadequate to the annoying factor. The use of psychoactive substances (alcohol, drugs) increases the likelihood of psychomotor agitation in a person with psychopathic or neurasthenic traits. Aggression, anger, anger is directed at individuals who have offended the patient, who did not appreciate his achievements. Most often expressed in threats, swearing, physical actions, suicide attempts, the demonstrative nature of which is intended to provide a wide audience, which is especially characteristic of the hysterical subtype of psychopathic arousal, when the game on the viewer is accompanied by violent affects. Facial expressions and gestures of the patient are expressively expressive and often even pretentious. It is noticeable that the "actor" appeals to the audience in order to achieve empathy. Unlike "real" patients (epileptics, people with organic brain diseases), psychopaths are well-versed in the situation and, in most cases, control the situation and can resist breaking the law because they realize that they will incur responsibility for their actions. However, there is no guarantee of safety, especially if the psychopath is under the influence of psychoactive substances.
With organic lesions of the brain and epileptics, dysphoric psychomotor agitation is often developed. The patient is tense, gloomy and gloomy, very suspicious. It often takes a defensive position, on attempts to establish contact, it reacts with sharp irritation and unexpected strong aggression, suicidal intentions are possible.
Maniacal excitement is accompanied by a euphoric mood, all movements and thoughts are focused on performing some purposeful action, while accelerated thinking is characterized by a lack of logic, attempts to prevent an individual in such a state can cause violent aggression. Patients often miss words in sentences, it seems that their actions do not keep up with the thought. The voice of patients acquires hoarseness and more than one of their actions is not brought to its logical conclusion.
Catatonic excitement - impulsive rhythmic repetitions of monotonous muffled muttering, singing, fighting, grimacing, jumping, shouting, frilly unnatural movements and poses. Manneredness is inherent in some patients - they greet everyone in a row and several times, trying to make small talk by asking the same questions.
Schizophrenics often experience hebephrenic arousal, a specific symptom of which is foolish behavior, however, it, following a sudden impulse, can turn into aggression with elements of delusions, illusory visions, mental automatism.
Epileptiform psychomotor agitation, which is most susceptible to epileptics with a temporal lesion, is accompanied by stupefaction, spatial and temporal disorientation, contact with the patient is impossible. Arises suddenly - is expressed by motor hyperactivity, aggressive actions. The patient defends himself from imaginary enemies, striving to escape from them. There is a viciously intense affect, often such seizures of excitement are accompanied by the commission of violent acts. The excited state lasts about one or two minutes, then also passes suddenly. After that, the patient does not remember his actions and for some time (at least 10 minutes) remains inaccessible for contact.
Eretic psychomotor agitation is observed in oligophrenics and in other forms of mental retardation. It manifests itself in unbiased destructive activity, devoid of any meaning, which is accompanied by abuse or loud meaningless sounds.
Delirious psychomotor agitation occurs under the influence of psychoactive substances or in chronic alcoholics, experienced addicts - such as withdrawal syndrome, as well - in case of injuries, neuroinfections, tumors. It is expressed by chaotic senseless movements, intense concentration, incoherent speeches, changeable facial expressions, aggressive gestures. This type of psychomotor excitement is almost always accompanied by delusions and hallucinations, under the influence of which patients are prone to making unmotivated attacks on imaginary enemies and / or self-damaging actions.
There is also delusional and hallucinatory stimulation. For delusional characterized by the presence of overvalued ideas for the patient. Patients in a state of delirium are aggressive, they see the surrounding enemies who impede the implementation of delusions. It is characteristic of schizophrenics and people with organic pathologies of the central nervous system.
In patients with hallucinatory arousal, first of all, very rich facial expressions, they are focused on their illusions, hostile to others, their speech is usually incoherent.
Diametrically opposite state is psychomotor inhibition or stupor. Hypo- and akinesia, diminished muscle tone, laconicism or just a dull silence are characteristic of this state. Sometimes the patient is available to contact, sometimes not. The causes and types that caused psychomotor inhibition are similar to arousal, in addition, one state can be replaced by another, sometimes quickly and unexpectedly.
Complications and consequences
The most significant result of psychomotor agitation is the infliction of bodily injuries that are incompatible with life, yourself or others. Less significant - minor injuries and damage to property. Especially dangerous are patients who cannot be contacted with catatonic and hallucinatory-delusional types of arousal, since their impulsive action cannot be predicted.
In addition, the occurrence of such a condition may indicate that the individual has serious mental or nervous system diseases that require urgent action.
Diagnosis of psychomotor agitation
Pre-hospital diagnostics is carried out visually. It is desirable for the physician to assess the degree of aggressiveness of the patient and the hypothetical cause of the state of psychomotor arousal. In addition, it is necessary to avoid aggression aimed directly at health workers.
It often does not make sense to ask the patient questions, because he does not want to contact.
However, some questions that will help to make a differential diagnosis should be clarified, if not from the patient himself, then from his close people: did the patient have such states before, which preceded the agitation, did the patient have a psychiatric or neurological diagnosis, did she take psychoactive substances the day before , whether there were injuries, whether they suffer from alcoholism, whether there have been attempts of suicide and others before.
On examination, the doctor should focus on identifying the specific symptoms of the patient’s condition, whether they are aggravated, delusions, hallucinations. Pay attention to the severity of affect, demonstrativeness, try to determine the severity of psychomotor arousal - as the patient says and moves (especially loud, non-stop, nonsensical speech and hyperkinetism combined with the lack of response to requests, comments, orders from others) are grounds for hospitalization.
Differential diagnosis is carried out between psychomotor excitations without and with psychotic symptoms. It is necessary to distinguish between psychogenic and psychopathic arousal from manic, epileptiform, schizophrenia, delirium.
Delirious disorders caused by taking psychoactive substances and requiring neutralization of their action from delirium due to other causes - neuroinfections, epilepsy, tumors. Affective disorders - from each other, in particular, a major depressive disorder (clinical depression), which is characterized by long-term mood retention in one state, differentiate from intermittent manic and depressive episodes (bipolar disorder). Stress also needs to be differentiated from mental illness, and the severity of the stress response indicates what measures to take.
Treatment of psychomotor agitation
In the overwhelming majority of cases, patients in a state of psychomotor excitement are dangerous, to a greater extent - to others, but sometimes they also show auto-aggression. To prevent undesirable consequences, urgent help with psychomotor agitation can prevent. The patient is tried to be isolated and not left alone, watching him, if possible, is not too noticeable, since demonstrative observation can cause an attack of aggression on the part of the patient. Be sure to call an ambulance. Usually, a psychiatric team is sent to such a call, before the arrival of which, in difficult cases, you can call the police, who are obliged by law, to provide psychiatric assistance.
The help algorithm at the pre-hospital stage is to prevent aggression from the patient with the help of persuasion, distraction of attention and physical strength (keeping the patient). Of course, first of all, if the patient is available to contact, they try to persuade him to take medicine or to allow him to give an injection and voluntarily go to the hospital.
In severe cases (the patient actively resists, threateningly behaves or has a weapon), law enforcement agencies are involved and help is provided without the patient’s consent.
Raging patients for the time it takes to transport, while the drugs have not yet worked, are temporarily immobilized or immobilized with the help of improvised means or a straitjacket.
The main recommendations for tying a patient into psychomotor agitation are that soft and wide materials are selected from the improvised means - sheets, towels, cloth belts that should not overpress blood vessels and the nerve trunks of the body. It is necessary to securely fix each patient's hand separately, as well as the shoulder girdle. Basically, this is enough. In especially violent and mobile patients, lower limbs are also immobilized. At the same time, it is necessary to make sure that it is impossible to free yourself from the fixing bandages. The condition of the immobilized patient must be constantly monitored.
Relief of psychomotor agitation is drug-induced, excluding cases of emergency surgery, when hyperactivity is a sign of progressive compression of the brain.
The most widely used drugs for psychomotor agitation are neuroleptics with a pronounced sedative effect. The most commonly used parenteral administration is intramuscular or intravenous. If the patient can be persuaded, parenteral forms of drugs can be used. Patients who have never been treated with neuroleptics are prescribed a minimally effective dose. Those who have previously been treated with psychotropic drugs - the dose is doubled. The patient is constantly monitored for blood pressure, respiratory function and the absence of signs of orthostatic phenomena. In milder cases, as well as for weakened and elderly patients, tranquilizers are prescribed. Naturally, these drugs are not combined with alcohol.
Drugs are dosed individually depending on the response of the patient to the treatment.
In cases of anxiety in the mild and middle stages, the medicine Atarax is prescribed. The active ingredient of the drug hydroxyzine dihydrochloride is an H1-histamine blocker, as well as the choline receptor, exhibits a moderate anxiolytic effect, besides it provides a hypnotic and anti-emetic effect. Is tranquilizer enough soft action. When anxious agitation in patients accelerates the process of falling asleep, improves the quality of sleep and its duration. The relaxing effect of the medicine on the muscles and the sympathetic nervous system contributes to this effect.
In addition, Atarax as a whole has a beneficial effect on memory, concentration and memorization, but this is a long-term effect. And during reception it is necessary to refuse to drive a car, work at height, with electrical wiring, etc.
The active ingredient is absorbed at a good rate in the gastrointestinal tract. The effect of taking the pills occurs in half an hour, and with intramuscular injection - almost instantly. As a result of taking the drug, there is no withdrawal syndrome, however, in elderly patients suffering from hepatic and renal failure, dose adjustment is required.
Atarax overcomes the placental barrier, cumulates in the tissues of the unborn child, penetrates into breast milk, so the drug is contraindicated for pregnant and lactating women.
Not prescribed to patients with porphyria and established allergies to the active substance or auxiliary, contained in the composition of the drug, in particular, lactose, as well as to cetirizine, aminophylline, piperazine, ethylene diamine and their derivatives.
The drug can cause an allergic reaction, although it has the ability to eliminate it, rare side effects are increased arousal, hallucinations and delusions.
Basically, it causes drowsiness, weakness, subfebrile, blurred vision, dyspepsia, hypotension.
For moderate psychomotor agitation, elderly and debilitated patients, as well as, with the aim of stopping pre-arousal arousal or symptoms of psychoactive substance withdrawal syndrome, the drug Grandaxin may be used. The active substance tofizopam belongs to the group of benzodiazepines. This drug reduces mental stress, reduces anxiety, has a slight sedative effect. However, it is believed that it does not cause drowsiness, muscle relaxation and anticonvulsant effect, therefore, when expressed psychomotor agitation, its use is impractical. The drug can cause an increase in arousal, dyspeptic symptoms and allergic reactions. In the first three months of pregnancy is prohibited, then - only for health reasons. Nursing women can be taken under the condition of cessation of lactation. Side effects are more often observed in people with hepatic and renal dysfunction, mentally retarded, and in old age.
With epilepsy, this drug can cause the occurrence of convulsions, in conditions of depressive anxiety and excitement, the risk of trying to get even with life increases, special caution should be exercised with patients who have organic brain disorders, as well as suffering from personality disorders.
Another benzodiazepine anxiolytic Relanium (the active ingredient - diazepam) is often used in emergency cases of acute psychomotor anxiety. It is used both orally and parenterally - intramuscularly and intravenously. The drug, unlike the previous one, has a pronounced hypnotic, anti-convulsive and muscle-relaxing action.
It interacts with benzodiazepine receptors located in the center of regulation of the activity of the brain and spinal cord, enhances the action of the inhibitory neurotransmitter γ-aminobutyric acid, both presynaptic and postsynaptic, and also inhibits polysynaptic spinal reflexes.
The sedative and hypnotic effect is realized mainly by influencing the neurons of the reticular formation of the brain stem.
Convulsions are stopped by suppressing the spread of epileptogenic activity, however, the stimulation in the epileptic focus remains intact.
Relanium weakens delirious arousal of alcoholic etiology, however, the productive manifestations of psychotic disorders (delusions, hallucinations) have almost no effect.
Contraindicated in severe respiratory failure, propensity to stop breathing during sleep and muscle weakness of the patient. Also not used in comatose conditions, for the treatment of patients with phobic disorders and chronic psychosis. Contraindicated in patients with glaucoma, especially with angle-closure, with severe liver and kidney dysfunctions. Chronic alcoholics and drug addicts are prescribed exclusively for the relief of arousal caused by withdrawal syndrome.
In bipolar and other types of mixed disorders with a predominance of the anxious component, the drug Amitriptyline can be used to relieve an attack of psychomotor agitation. It belongs to the class of tricyclic antidepressants, is available both in tablet and injectable form. Increases the concentration of catecholamines and serotonin in the synaptic cleft, inhibiting the process of their reuptake. Blocks choline and histamine receptors. Improving mood when taking the drug at the same time supported by sedation - a decrease in anxiety.
It is believed that it does not affect the activity of monoamine oxidase. At the same time, it is not prescribed in combination with other antidepressants that suppress monoamine oxidase. If it is necessary to replace Amitriptyline with a monoamine oxidase inhibitor, the interval between taking the preparations should be at least two weeks.
Paradoxical side effects are possible, as well as increased sleepiness, headache, coordination disorder, dyspepsia. The drug is not recommended to appoint in the manic phase of bipolar disorder, epileptics and patients with suicidal tendencies. Contraindicated in children up to the age of twelve, with special care is prescribed to men suffering from prostate adenoma, people of both sexes with dysfunction of the thyroid gland, heart and blood vessels, glaucoma, patients who have had a myocardial infarction, pregnant and lactating women.
Hypnotic drug with antipsychotic action Tiaprid blocks the adrenoreceptors of the brain stem. At the same time, it has an antiemetic effect by blocking dopamine neurotransmitter receptors in the chemoreceptor trigger zone of the brain, as well as in the hypothalamic center of thermoregulation.
The drug is indicated for the treatment of patients older than six years of age in a state of psychomotor excitement of various origins, including alcohol, drug and senile aggression. Oral drug is taken with minimal doses, bringing to effective.
Non-contact patients are given an injection every four or six hours. The doctor prescribes the dose, but per day you can get no more than 0.3 g of the drug for a child and 1.8 g for an adult. Injectable form is used to treat patients from seven years.
Contraindicated in the first four months of pregnancy, nursing mothers, patients with prolactin-dependent tumors, pheochromocytoma, decompensated and severe cardiovascular and renal pathologies.
Epileptics and elderly patients are prescribed with caution.
Adverse effects from taking the drug can be expressed in the strengthening of the hypnotic effect or paradoxical effects, hyperprolactinemia, allergic reactions.
The most versatile and widely used nowadays in stopping the state of psychomotor arousal in different stages are antipsychotics, the most popular of which is Aminazin. This neuroblocker has proven to be an effective means of combating hyper-arousal and is used in many countries of the world under various names: Chlorpromazine (English version), Megafen (Germany), Largactil (France).
This drug has a diverse and complex dose-dependent effect on the work of the central and peripheral nervous system. Increasing the dose causes an increase in sedation, the musculature of the patient's body relaxes and motor activity decreases - the patient's condition approaches the normal physiological state of sleep, which differs from the narcotic one in that it is devoid of side effects of anesthesia –– deafness, characterized by ease of awakening. Therefore, this drug is the drug of choice for the relief of states of motor and speech arousal, anger, rage, unmotivated aggression in conjunction with hallucinations and delusions.
In addition, the drug, acting on the center of thermoregulation, is able to lower body temperature, which is valuable when excited due to acute brain injuries, hemorrhagic strokes (when hyperthermia is often observed). Such an action is potentiated by the creation of artificial cooling.
In addition, Aminazin has antiemetic ability, calms the hiccups, which is also important in the above cases. Potentiates the action of anticonvulsants, painkillers, narcotic, sedatives. Able to arrest episodes of hypertension caused by the release of adrenaline and other interoceptive reflexes. The drug has a moderate anti-inflammatory and angioprotective activity.
The mechanisms of its action have not yet been fully studied, but its effectiveness is not in doubt. Research data in different countries indicate that the active substance (a derivative of phenothiazine) has a direct impact on the occurrence and conduction of nerve impulses that transmit excitation in different parts of both the central and the autonomic nervous system. Under the influence of the drug, metabolic processes in the brain tissues are slowed down, especially in the neurons of its cortex. Therefore, the neuroplegic effects of the drug are associated with cortical activities. In addition, Aminazin acts on the subcortex, the reticular formation and peripheral nerve receptors, suppresses almost all types of psychomotor agitation, relieves hallucinatory and delusional symptoms, however, is not a hypnotic. A patient under the influence of this drug is able to adequately respond and answer questions.
It is used both independently and in combination with anxiolytics and other psychotropic drugs. The absolute contraindications to the use of drugs are severe systemic pathologies of the brain and spinal cord, liver and kidney dysfunction, blood-forming organs, myxedema, a tendency to thromboembolism, decompensated heart disease.
Apply at any age, dosed individually, according to age norms and the severity of the condition. Oral administration is possible, as well as parenteral (intramuscular and intravenous). In order to avoid postinjection complications and painful sensations, the contents of the ampoule are diluted with novocaine or lidocaine, saline, glucose solution (intravenous administration).
After using the drug, especially the injection, a drop in blood pressure is possible, therefore the patient is recommended to lie down for several hours and take an upright position without sudden movements.
In addition, other side effects are possible - allergy, dyspepsia, neuroleptic syndrome.
The drug Fenotropil - a new word in improving the work of the central and peripheral nervous system. Nootropic, which came to a wide consumer from space medicine. The pharmacological effect of the drug is close to the natural - its manufacturers claim that the drug can activate more rational use of its own resource, and not lead to its depletion.
The drug has a beneficial effect on metabolic processes in the neurons of the brain and stimulates blood circulation in the cerebral vessels. It activates the course of redox processes, increases the efficiency of glucogenesis, thus increasing the energy potential of the body. The active ingredient of the drug phenylpyracetam increases the content of mediators of vitality, pleasure and good mood - norepinephrine, dopamine and serotonin. It is not necessary to list all of its remarkable qualities, but note that it is directly related to the relief of psychomotor agitation. The drug has a psychostimulant effect - accelerates the transmission of nerve impulses, improves performance, cognitive qualities, has a moderate anti-anxiety activity. However, in the features of the application, it is noted that people who are prone to panic attacks and bouts of psychotic arousal should be used with caution. The drug is more suitable for the prevention of psychomotor agitation and increase the body's stress resistance. He has no direct indications for stopping the state of motor and mental hyperactivity. On the contrary, it is shown in cases of decreased mobility, lethargy, memory impairment and manifestations of anxiety inhibition.
Different agents with sedative properties are used for the treatment of psychomotor agitation: barbiturates - veronal, medinal, luminal, chloral hydrate and others. They have a pronounced hypnotic effect. They are sometimes prescribed rectally (in enema). The effectiveness of such funds increases with simultaneous intravenous sulfate magnesia.
In severe cases, they resort to fast-acting, often narcotic, drugs (thiopental-sodium, Hexenal) and their intravenous administration. A complication of such therapy may be apnea and acute impairment of the activity of the heart muscle.
The effect of Reserpine in cases of psychomotor agitation resembles the action of Aminazine. It is not a hypnotic, but potentiates natural sleep and relieves arousal, providing a central effect. Patients feel calm, muscular relaxation, fall asleep calm and deep sleep. This process is accompanied by a decrease in blood pressure. Hypotension remains after the abolition of Reserpine. Normalization of pressure after discontinuation of the drug occurs as gradually as its decrease under the action of the drug. This drug is indicated for hypertensive patients with acute psychomotor agitation. Contraindicated in epileptics and other patients prone to seizures.
After placing a patient with psychomotor agitation in the inpatient unit and rendering first aid (stopping arousal), he is continued to be monitored in a special ward, since the stability of his condition is in question and there is a possibility that the attack will resume.
To prevent an accident or catastrophe, other serious stressors are almost impossible. However, trying to improve their stress resistance is necessary.
First, it concerns general health. Proper nutrition, the absence of bad habits, physical activity provides the highest possible immunity and reduces the likelihood of developing acute psychogenic reactions.
Secondly, a positive view of the world, an adequate and objective self-esteem of the individual also reduces the risk of pathology.
Thirdly, if there are diseases of any etiology, you should not start them and undergo the necessary treatment courses.
People exposed to stress and acutely reacting to them should do psychocorrection - use any re-axing factors (yoga, meditation, music, nature, pets, different types of training under the guidance of specialists). You can take pharmacocorrection courses under the guidance of a phytotherapist, a homeopath, a neurologist.
Timely assistance can prevent the danger of this condition for others and for the patient. The psychomotor agitation of mild and sometimes moderate severity can be eliminated without hospitalization, by an emergency psychiatric team. Severe cases with non-contact patients require special care, the use of special measures and mandatory hospitalization. After stopping an attack of arousal, further development of events is determined by the nature of the underlying disease.