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Treatment of Agitation

Because of its disruption of therapeutic goals, significant agitation during rehabilitation has to be addressed, and various behavioral, environmental and pharmacological interventions have been used. Effective treatment requires the involvement of the entire interdisciplinary rehabilitation team. The identification and elimination of antecedents or triggers of agitation is often the most effective behavioral approach. Possible antecedents include: medical problems that reduce cognition or increase discomfort; the presence of environmental demands that exceed the person's cognitive abilities at the time; and/or a chaotic, unstructured environment (Flanagan et al., 2009). Agitation can be reduced through the provision of structured rehabilitation and supports to maximize cognitive functioning.

With regard to the pharmacological interventions, the research literature is sprinkled with studies of the effectiveness of various medications in improving agitation. While there is not clinical consensus about which medications are effective in what circumstances (Fugate et al., 1997; Francisco et al., 2007), there is an understanding that those pharmacologic interventions which reduce agitation through sedation can delay, if not prevent, patients' cognitive and functional improvement during the acute phase of recovery (Mysiw & Sandel, 1997). Studies have shown that an improvement in cognition was a prerequisite to improved agitation (Corrigan and Mysiw, 1988; Nott et al., 2010).

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This website has been funded with financial assistance from Grant #H133A120086 awarded by the U.S. Department of Education, National Institute on Disability Rehabilitation Research (NIDRR) to the Ohio Valley Center for Brain Injury Prevention and Rehabilitation for the current funding period of 10/01/2012 - 09/30/2017.