Send Feedback

Print

 Back

Canterbury DHB

Agitation

• Attempt to identify and reverse causes.
• Exclude acute delirium and treat if required as per Delirium Section.
• Manage any symptoms of acute anxiety.
• Spiritual, social and religious issues require a multi-disciplinary approach.
• Precipitants such as fear (requiring explanation and reassurance or the presence of a relative) or unrelieved physical symptoms must be addressed, e.g. constipation, urinary retention, and alcohol or nicotine withdrawal.
• An antidepressant may need to be considered.

Treatment with benzodiazepines may be necessary:

• Clonazepam 0.25 – 1 mg nocte – tabs or oral drops 0.1 mg/drop (1-5 drops q6h prn).
• Lorazepam 0.5 - 2 mg PO/SL, 4 - 6 hourly.
• Diazepam 2 - 10 mg PO or PR, 8 - 12 hourly.

Note: Sedation may occasionally be indicated in the terminally ill when agitation or extreme fear is unrelieved – a referral to the Palliative Care Service is strongly recommended. See Terminal Agitation Section.

Caution: Clonazepam has a long half-life and can accumulate in repeated dosing.

Topic Code: 4139