Drug induced akathisia is classified as an extrapyramidal adverse effect. Although akathisia is quite common extrapyramidal adverse effect, it is often overlooked or mistaken for restlessness or agitation of another etiology. Drugs associated with the risk of extrapyramidal adverse effects (antipsychotics, antiemetics, antidepressants) belong to frequently used pharmacotherapy. The use of these drugs is often complicated by serious condition of a patient and several other comorbidities, which increase the risk of the aforementioned adverse effects. In many situations, akathisia can be more difficult to recognize and more easily attributed to non-drug etiology, especially outside the fields of psychiatry and neurology. The variability of the clinical symptoms and the similarity to other clinical entities that occur frequently (anxiety, delirium, agitated depression, restless legs syndrome, etc.) can lead to difficult determination of the etiology and to the administration of medication, which tends to worsen the problem. At the same time, akathisia can be a source of very strong distress for a patient and fundamentally reduce his quality of life.

• Klíčová slova
• drug-induced movement disorders, akathisia, antipsychotics, antidepressants, antiemetics,
• MeSH
• antipsychotika škodlivé účinky   MeSH
• lidé MeSH
• poléková akatizie * etiologie   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antipsychotika MeSH

Neuroleptic malignant syndrome is a life-threatening condition that can be fatal if unrecognized and inadequately treated. This disease is rarely seen in infectious diseases wards. As infectiologists, however, we are confronted with an increasingly broader spectrum of diagnoses and this disease should therefore be considered in any patient taking psychiatric medication who develops the typical symptoms of hyperthermia, rigidity and muscle tremors, autonomic lability and impaired consciousness. A case report is presented of a young man with schizophrenia admitted to the intensive care unit with COVID-19, who was treated with antipsychotics (formerly known as neuroleptics) for restlessness and who developed neuroleptic malignant syndrome. In cooperation with psychiatrists, a targeted therapy was initiated, after which the symptoms subsided and the patient's clinical condition resolved.

• MeSH
• antipsychotika * škodlivé účinky   MeSH
• COVID-19 * komplikace   MeSH
• lidé MeSH
• maligní neuroleptický syndrom * diagnóza   etiologie   terapie   MeSH
• psychomotorický neklid komplikace   farmakoterapie   MeSH
• schizofrenie * komplikace   farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antipsychotika * MeSH

• MeSH
• agrese psychologie   MeSH
• demence psychologie   MeSH
• lidé MeSH
• pečovatelské domovy * MeSH
• psychomotorický neklid psychologie   MeSH
• senioři MeSH
• syndrom MeSH
• terminologie jako téma * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• úvodníky MeSH

One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer's disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23-3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00-6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD.

• Klíčová slova
• Agitation, Alzheimer’s disease, FDG-PET, anxiety, apathy, cognitively normal persons, depression, neuroimaging, neuropsychiatric symptoms,
• MeSH
• apolipoproteiny E genetika   MeSH
• deprese diagnostické zobrazování   patofyziologie   MeSH
• fluorodeoxyglukosa F18 metabolismus   MeSH
• kognice fyziologie   MeSH
• kognitivní dysfunkce komplikace   MeSH
• lidé MeSH
• mozek diagnostické zobrazování   MeSH
• neuropsychologické testy MeSH
• pozitronová emisní tomografie MeSH
• průřezové studie MeSH
• psychiatrické posuzovací škály MeSH
• psychomotorický neklid * diagnostické zobrazování   patofyziologie   psychologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stárnutí * MeSH
• úzkost * diagnostické zobrazování   patofyziologie   psychologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• apolipoproteiny E MeSH
• fluorodeoxyglukosa F18 MeSH

BACKGROUND: This position statement provides clinical recommendations for the assessment of pain, level of sedation, iatrogenic withdrawal syndrome and delirium in critically ill infants and children. Admission to a neonatal or paediatric intensive care unit (NICU, PICU) exposes a child to a series of painful and stressful events. Accurate assessment of the presence of pain and non-pain-related distress (adequacy of sedation, iatrogenic withdrawal syndrome and delirium) is essential to good clinical management and to monitoring the effectiveness of interventions to relieve or prevent pain and distress in the individual patient. METHODS: A multidisciplinary group of experts was recruited from the members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). The group formulated clinical questions regarding assessment of pain and non-pain-related distress in critically ill and nonverbal children, and searched the PubMed/Medline, CINAHL and Embase databases for studies describing the psychometric properties of assessment instruments. Furthermore, level of evidence of selected studies was assigned and recommendations were formulated, and grade or recommendations were added on the basis of the level of evidence. RESULTS: An ESPNIC position statement was drafted which provides clinical recommendations on assessment of pain (n = 5), distress and/or level of sedation (n = 4), iatrogenic withdrawal syndrome (n = 3) and delirium (n = 3). These recommendations were based on the available evidence and consensus amongst the experts and other members of ESPNIC. CONCLUSIONS: This multidisciplinary ESPNIC position statement guides professionals in the assessment and reassessment of the effectiveness of treatment interventions for pain, distress, inadequate sedation, withdrawal syndrome and delirium.

• Klíčová slova
• Assessment, Delirium, Distress, Pain, Sedation, Withdrawal syndrome,
• MeSH
• abstinenční syndrom diagnóza   terapie   MeSH
• delirium diagnóza   terapie   MeSH
• dítě MeSH
• hypnotika a sedativa terapeutické užití   MeSH
• jednotky intenzivní péče normy   MeSH
• kojenec MeSH
• konsensus MeSH
• kritický stav * MeSH
• lidé MeSH
• management bolesti metody   MeSH
• měření bolesti metody   MeSH
• novorozenec MeSH
• pooperační delirium diagnóza   terapie   MeSH
• předškolní dítě MeSH
• psychický stres MeSH
• psychomotorický neklid diagnóza   farmakoterapie   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• hypnotika a sedativa MeSH

BACKGROUND: Use of antipsychotic (AP) medications is high and often inappropriate among institutionalized populations. Little is known about the correlates of new AP drug use following admission to long-term care (LTC) settings. This study investigated the frequency and correlates of new AP drug use among newly admitted LTC residents. METHODS: This longitudinal, retrospective study used data from the interRAI - Nursing Home Minimum Data Set version 2.0 (MDS 2.0) instrument. Data about demographic, clinical and social characteristics, and medication use, were collected in Ontario, Canada, from 2003-2011 by trained nurses. Residents with complete admission and 3-6 month follow-up data were included (N = 47,768). Multivariate logistic regression analyses, stratified by gender, explored correlates of new AP drug use upon admission to LTC. RESULTS: New AP drug users comprised 7 % of the final cohort. Severe cognitive impairment, dementia, and motor agitation were significantly associated with new AP drug use among both sexes. Additionally, behavioural problems, conflicts with staff and reduced social engagement were strong correlates of new AP drug use. CONCLUSIONS: Social factors were as strongly associated with new AP drug use after LTC admission as clinical factors. Strategies to prevent the potential misuse of AP drugs upon LTC admission should consider the social determinants of such prescribing.

• MeSH
• antipsychotika terapeutické užití   MeSH
• demence farmakoterapie   epidemiologie   psychologie   MeSH
• dlouhodobá péče psychologie   trendy   MeSH
• lidé MeSH
• longitudinální studie MeSH
• následné studie MeSH
• pečovatelské domovy trendy   MeSH
• příjem pacientů trendy   MeSH
• psychomotorický neklid farmakoterapie   epidemiologie   psychologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Ontario epidemiologie   MeSH
• Názvy látek
• antipsychotika MeSH

• MeSH
• akutní nemoc MeSH
• antipsychotika škodlivé účinky   MeSH
• dystonie chemicky indukované   diagnóza   psychologie   MeSH
• isoxazoly škodlivé účinky   MeSH
• lidé MeSH
• mladý dospělý MeSH
• paliperidon palmitát MeSH
• palmitany škodlivé účinky   MeSH
• poléková akatizie diagnóza   psychologie   MeSH
• stupeň závažnosti nemoci * MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antipsychotika MeSH
• isoxazoly MeSH
• paliperidon palmitát MeSH
• palmitany MeSH

BACKGROUND: Nocturnal sleep of patients suffering from various forms of dementia is often impaired by nocturnal agitation or nocturnal wandering. Anticonvulsives such as carbamazepine or valproate are reported to have some therapeutic efficacy, but there is little information about other drugs suitable for treatment of this condition. CASE REPORT: Our patient, a 77-year-old Czech woman with incipient vascular dementia, received gabapentin 400mg at bedtime for 6 months and showed convincing improvement. CONCLUSIONS: Gabapentin was very effective in treating nocturnal agitation.

• MeSH
• aminy terapeutické užití   MeSH
• anxiolytika terapeutické užití   MeSH
• demence komplikace   farmakoterapie   MeSH
• GABA terapeutické užití   MeSH
• gabapentin MeSH
• kyseliny cyklohexankarboxylové terapeutické užití   MeSH
• lidé MeSH
• psychomotorický neklid komplikace   farmakoterapie   MeSH
• senioři MeSH
• tma * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• aminy MeSH
• anxiolytika MeSH
• GABA MeSH
• gabapentin MeSH
• kyseliny cyklohexankarboxylové MeSH

Few studies have reported neuropsychiatric symptoms (NPS) in primary progressive aphasia (PPA), a neurodegenerative disorder that primarily affects the left hemisphere. Depression is associated with left-sided stroke, but it remains unclear whether depression and other NPS are also associated with PPA. The authors compared the frequency of neuropsychiatric symptoms in 55 cases of PPA with 110 cognitively normal persons matched for age, sex, and education. Depression, apathy, agitation, anxiety, appetite change, and irritability are associated with PPA. Hallucinations, delusions, and night-time behavior were not associated with PPA.

• MeSH
• apatie MeSH
• deprese diagnóza   psychologie   MeSH
• lidé MeSH
• neuropsychologické testy MeSH
• primární progresivní afázie psychologie   MeSH
• psychomotorický neklid diagnóza   psychologie   MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• úzkost diagnóza   psychologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

OBJECTIVES: To determine modifiable factors related to abusive behaviors in nursing home residents with dementia. DESIGN: Analysis of Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI) information. SETTING: We used MDS-RAI data from 8 Dutch nursing homes and 10 residential homes that volunteered to collect data for care planning. We included the data of residents within a 12-month time window for each facility separately, resulting in a range from April 4, 2007, to December 1, 2008. PARTICIPANTS: We selected 929 residents older than 65 with Alzheimer's disease or other dementia who were dependent in decision making and not comatose. MEASUREMENTS: Cognitive Performance Scale, MDS Depression Scale and several individual items from the MDS-RAI (ability to understand others, verbally and physically abusive behavioral symptoms, resist care, diagnosis of Alzheimer's disease and of dementia other than Alzheimer's disease, diagnosis of depression, presence of delusions, hallucinations, pain frequency and constipation, and number of days receiving medications). RESULTS: Resistiveness to care, related to lack of understanding, depression, hallucinations and delusions, was strongly related to abusive behaviors. Presence of depressive symptoms and delusions was also related to abusive behaviors independent of resistiveness to care. Only very few residents who understood others and were not depressed were abusive. CONCLUSION: Abusive behaviors may develop from lack of understanding leading to resistiveness to care. Behavioral interventions preventing escalation of resistiveness to care into combative behavior and the treatment of depression can be expected to decrease or prevent abusive behavior of most nursing home residents with dementia.

• MeSH
• agrese psychologie   MeSH
• Alzheimerova nemoc komplikace   psychologie   MeSH
• databáze faktografické MeSH
• demence komplikace   psychologie   terapie   MeSH
• domovy pro seniory * MeSH
• incidence MeSH
• kognitivní poruchy komplikace   psychologie   terapie   MeSH
• kohortové studie MeSH
• lidé MeSH
• logistické modely MeSH
• multivariační analýza MeSH
• odmítnutí terapie pacientem MeSH
• pečovatelské domovy * MeSH
• pravděpodobnost MeSH
• psychiatrické posuzovací škály MeSH
• psychomotorický neklid epidemiologie   etiologie   MeSH
• rizikové faktory MeSH
• rozložení podle pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• věkové rozložení MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH