Infection
Medications
Electrolyte imbalances |
Table 1: Common underlying causes of delirium in the ID population
Orientation
Comfort
Avoid over-stimulation |
Table 2: Environmental measures for delirium-related agitation
|
Characteristics |
Onset |
Treatment |
Acute Dystonia |
Muscle spasm or stiffness (e.g., torticollis, trismus), tongue protrusions, oculogyric crisis |
Usually occurs within the first hours or days of treatment and is most common in young males |
Diphenhydramine, anticholinergics (benztropine, trihexyphenidyl) |
Akathisia |
Subjective feeling of restlessness and is in constant motion, unable to sit still, pacing, alternating sitting and standing |
Usually occurs within the first few days of treatment. Most commonly occurs with the atypical antipsychotic Aripiprazole |
Propranolol, |
Parkinsonism |
Stiffness, cogwheel rigidity, shuffling gait, mask-like facies and is most common in elderly females |
Usually occurs within the first few months of treatment, related to antipsychotic-induced dopamine depletion |
Diphenhydramine, anticholinergics (benztropine, trihexyphenidyl) |
Tardive Dyskinesia |
Perioral movements (darting or protruding movements of the tongue, chewing, grimacing, puckering). choreoathetosis of the head, limbs, trunk. |
Usually presents after years of treatment |
Valbenazine, deutetrabenazine, |
Table 3: Antipsychotic-induced extrapyramidal symptoms
Tables at a glance