Research Article The Outcome of Agitation in Poisoned Patients in an Iranian Tertiary Care University Hospital Ali Mohammad Sabzghabaee, 1 Ahmad Yaraghi, 2 Elham Khalilidehkordi, 3 Seyyed Mohammad Mahdy Mirhosseini, 3 Elham Beheshtian, 3 and Nastaran Eizadi-Mood 1 1 Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2 Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 3 Department of Clinical Toxicology, Noor and Ali-Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran Correspondence should be addressed to Nastaran Eizadi-Mood; izadi@med.mui.ac.ir Received 7 August 2014; Revised 8 September 2014; Accepted 8 September 2014; Published 4 December 2014 Academic Editor: Mamede de Carvalho Copyright © 2014 Ali Mohammad Sabzghabaee et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Tis study was conducted to evaluate and document the frequency and causes of agitation, the symptoms accompa- nying this condition in intoxications, relationship between agitation score on admission and diferent variables, and the outcome of therapy in a tertiary care referral poisoning center in Iran. Methods. In this prospective observational study which was done in 2012, 3010 patients were screened for agitation at the time of admission using the Richmond Agitation Sedation Scale. Demographic data including age, gender, and the drug ingested were also recorded. Te patients’ outcome was categorized as recovery without complications, recovery with complications (hyperthermia, renal failure, and other causes), and death. Results. Agitation was observed in 56 patients (males,  = 41), mostly aged 19–40 years ( = 38) and more frequently in illegal substance (stimulants, opioids and also alcohol) abusers. Agitation score was not signifcantly related to the age, gender, and previous history of psychiatric disorders. Forty nine patients had recovery without any complication. Te need for mechanical ventilation was the most frequent complication. None of the patients died. Conclusion. Drug abuse seems to be a must-to-consider etiology for patients presenting with acute agitation and its morbidity and mortality could be low in agitated poisoning cases if prompt supportive care is performed. 1. Introduction Agitation is defned as restlessness accompanied by excessive and aimless motor or cognitive activity, which is usually expe- rienced by tension and anxiety [1, 2]. Te underlying causes of agitation fall into fve most prevalent categories includ- ing neurological diseases, drug intoxication or withdrawal symptoms, psychological disorders, metabolic diseases, and infections [3, 4]. Clinically, in intoxicated cases agitation is presented as frequent movements of head and limbs and attempt for extubation despite attempts of the staf to calm the patient [5]. Agitation could lead to diferent complications such as malignant hyperthermia, rhabdomyolysis, renal fail- ure, and even death [6]. Several agents and conditions are suspected to cause agitation afer poisoning or overdose [7, 8]. Tese include the abuse of drugs such as cocaine, amphetamine, and hallucino- gens; the withdrawal syndrome of alcohol, sedatives, and opi- oids; and intoxication with anticholinergic, antihistamines, tricyclic antidepressants, neuroleptics, monoamino oxidase inhibitors, and salicylic acid. Previous studies on patients with antihistamine and methamphetamine intoxication have shown that only some of these patients experience agitation [9, 10]. Moreover, agitation has been reported as an unusual presentation in intoxication of some drugs such as baclofen, olanzapine, phenytoin, risperidone, aripiprazole, adrenaline, and abuse of dextromethorphan [11–17]. Studies on agitated critically ill patients hospitalized in intensive care units (ICUs) have shown that presence of agitation is associated with prolonged duration of hospital- ization in ICU, higher prevalence of nosocomial infections, unplanned extubation, higher morbidity rate, and higher Hindawi Publishing Corporation Neurology Research International Volume 2014, Article ID 275064, 5 pages http://dx.doi.org/10.1155/2014/275064