Causes of anxiety

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Clonidine, sulfonamides, thiazides, nitrates/nitrites, quinidine

Delirium, anxiety, agitation, hypomania, depression, psychosis, dementia, sedation, sleep disturbances, altered color perception, vertigo, confusion

Anxiety, depression, confusion, psychosis, behavioral disturbances

Anxiety, depression, hostility, emotional lability, psychosis

Anxiety, depression, irritability

Encephalopathy, irritability, sedation, anxiety, hallucinations

Sleep disturbances, anxiety, mood disorders, psychosis

Chloroquine, mefloquine, quinine. Anxiety, panic, depression, suicidality, hallucinations, psychosis, vertigo, altered color perception, delirium, confusion

Ritonavir, didanosine, lopinavir + ritonavir, saquinavir, enfuvirtide.

Anxiety, agitation, mood disorders, depression, sleep disturbance, confusion, psychosis, lethargy

Depression, mania, paranoid delusions, hallucinations, anxiety, panic, confusion, delirium, suicidal behavior, violence

Testosterone, Methyltestosterone, Nandrolone

Psychosis, hypomania, mania, depression, anxiety, aggression, violence, suicide

Anxiety, depression, psychosis, cognitive impairment, delirium

Benztropine, Trihexyphenidyl, Diphenhydramine, Biperiden, Procyclidine, Tricyclic antidepressants, Antipsychotics

Anxiety, agitation, hypertension, hyperthermia, tachycardia, mydriasis, dry mouth, urinary retention, altered mental status, hallucinations, aggression, seizures, coma, death

Levodopa, amantadine, pergolide, apomorphine, lisuride, bromocriptine, ropinirole, cabergoline, pramipexole

Anxiety, irritability, depression, fatigue, euphoria, visual hallucinations, psychosis, delirium, sleep disturbance, psychomotor agitation, akathisia, cognitive impairment

Alprazolam, Lorazepam, Clonazepam, Temazepam, Diazepam, Midazolam, Triazolam

Decreased cognition, anterograde amnesia. Paradoxical aggression/disinhibition: excitement, mania, violence, irritability, agitation, panic, hyperactivity, paranoia, hallucinations, insomnia, delirium, confusion, behavioral disturbances, ataxia, dysphoria, crying

Hallucinations, sensory distortion, delirium, panic, amnesia, nocturnal eating, sleep walking/driving, agitation

Skeletal muscle relaxants. Sleep disturbance, anxiety, agitation, psychosis, delirium, mood disturbance

Fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine, venlafaxine, duloxetine, desvenlafaxine

Anxiety and agitation during first several weeks of treatment (especially if initiated at high dose), sexual dysfunction, nausea, diarrhea, sleep disturbances, anorexia, weight gain, headaches, tremor, dry mouth, diaphoresis, mammoplasia, gynecomastia, nausea, serotonin syndrome

Clozapine, olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, asenapine, lurasidone

Anxiety, weight gain, agranulocytosis, tardive dyskinesia, QTc prolongation, hyperprolactinemia, serotonin syndrome, neuroleptic malignant syndrome, EPS, metabolic syndrome, priapism, seizures

Sleep disorders, fatigue, agitation, anxiety, mood disturbances, hallucinations, psychosis, delirium, tinnitus, tachypnea, deafness, hyperpyrexia, headaches, seizures, coma, death

Fatigue, anxiety, panic

Anxiety, perceptual distortions, illusions, hallucinations, synethesia, paranoid ideation, ideas of reference, affect lability, depersonalization, panic, depression, suicidal ideation, hyperreflexia, tremor, hypertension, hyperthermia, tachycardia, headaches, myalgias, ataxia, dyspnea, renal failure, nausea/vomiting, weakness, seizures

Empathy, heightened awareness, increased energy, depression, depersonalization, derealization, mydriasis, anorexia, anxiety, panic, paranoid psychosis, tachycardia, dry mouth, palpitations, bruxism, hyperthermia, hypertension, rhabdomyolysis, serotonin syndrome, neurotoxicity, hyponatremia, seizures, liver toxicity, cardiotoxicity, DIC, death

PCP, Ketamine

Altered mental status, anxiety, dysphoria, psychosis, violence, delirium, hyperthermia, rhabdomyolysis, seizures, nystagmus

Amphetamine, Methamphetamine, Methylphenidate

Anxiety, elevated mood, increased energy, increased speech rate, hypersexuality, agitation, impaired judgment, insomnia, tics, paranoid delusions, aggression/violence, panic, stereotypic behaviors, hypertension, cardiac arrhythmia, seizures, hyperthermia, encephalopathy, CVA, MI, neurotoxicity, cardiotoxicity, liver toxicity, death

Hyperalertness, increased energy, anxiety, panic, insomnia, flushing, psychomotor agitation, irritability, hyperthermia, tachypnea, headaches, hypertension, sensory disturbances, arrhythmias, seizures, rhabdomyolysis, tremor, delirium, death

Anxiety, perceptual distortions, illusions, hallucinations, synethesia, paranoid ideation, ideas of reference, affect lability, depersonalization, panic, depression, suicidal ideation, hyperreflexia, tremor, hypertension, hyperthermia, tachycardia, headaches, myalgias, ataxia, dyspnea, renal failure, nausea/vomiting, weakness, seizures

Euphoria, hypersexuality, hypervigilance, anxiety, agitation, diaphoresis, hypertension, hyperthermia, visual hallucinations, paranoid delusions, delirium, seizures, MI, CVA, encephalopathy, neurotoxicity, death

Heroin, Morphine, Oxycodone, Hydromorphone, Hydrocodone, Meperidine, Fentanyl

Euphoria, dysphoria, apathy, itching, somnolence, anorexia, constipation, nausea, vomiting, respiratory suppression, cardiac arrhythmia, cognitive deficits, delirium, visual hallucinations, anxiety, depression, confusion, coma, seizures, death

Anxiety, agitation, depression, fatigue, hypersomnolence, hyperphagia, anhedonia

Anxiety, irritability, insomnia, anorexia, myalgias

Heroin, morphine oxycodone, hydromorphone, hydrocodone, meperidine, fentanyl, methadone

Anxiety, dysphoria, nausea, vomiting, myalgia, lacrimation, rhinorrhea, insomnia, yawning, diarrhea, hypertension, fever, craving

Benzodiazepines, Zolpidem, Barbiturates

2 or more - tremors, sweating, insomnia, nausea / vomiting, transient hallucinations, agitation, anxiety, seizures

2 or more - tremors, sweating, insomnia, nausea / vomiting, transient hallucinations, agitation, anxiety, seizures and delirium tremens. Stages

2 or more - Dizziness, paresthesias, anxiety, diarrhea, fatigue, gait instability, headache, insomnia, irritability, nausea / vomiting, tremors, visual disturbances. May also have myoclonus

Sudden onset of persistent motor or sensory dysfunction. more

History of trauma: unilateral headache and pupillary enlargement, and stupor, coma, and hemiparesis if large. more

Physical and cognitive impairment with a step-wise progression. hypertension is frequent. more

MI, Cardiomyopathy, CHF. more

Traumatic brain injury associated with headaches, cognitive dysfunction, dizziness, and neuropsychiatric symptoms. more

Headaches-classic "early morning" nausea/vomiting, seizures, syncope, neurologic deficits. more, causes of SOL

Cough, hemoptysis, chest pain, dyspnea, hoarseness. Associated with smoking. more

Abdominal pain and weight loss out of proportion to the degree of psychological symptoms. Anorexia, early satiety, back pain in more progressive disease. Diabetes might also be present. more

Acute or subacute mood/behavioral changes, short-term memory problems, complex-partial seizures, cognitive dysfunction. Also hyperthermia, somnolence, and endocrine abnormalities. Most common associated malignancies - lung (small cell carcinoma; SCC), testicular, breast, ovarian, thymoma, Hodgkin lymphoma. Or there may be no malignancy [i.e. non-neoplastic]. more, cases

Repeated seizures without a causative factor. Seizures may be followed by a post-ictal period of depression or psychosis.more

Headache, Nuchal rigitity, Fever, Nausea, Vomiting, Altered LOC, Focal deficits, Seizures. more

Fever, vomiting, abdominal pain, icterus. more

Fatigue, fever, lymphadenopathy, pharyngitis, rash, and GI complaints. more

Pharyngitis, fever, cervical lymphadenopathy, splenomegaly, and atypical lymphocytosis. more

Fever, weakness, fatigue, confusion, delirium, lethargy, depression, anxiety, apathy, irritability/agitation, cognitive impairment, seizures, cranial nerve palsies, acute flaccid paralysis, coma, deathmore

Irritability, anxiety, depression, personality changes, hallucinations, delirium, seizures, memory loss, aphasia, behavioral disturbances, seizures, fever, headaches, cranial nerve palsies, weakness. more

Undulant fever - a bacterial zoonosis transmitted to humans from infected animals: septic arthritis, neurologic involvement. more

Fever, night sweats, weight loss, fatigue, loss of appetite, cough and hemoptysis. more

Primary - chancre. Secondary: rash including palms and soles, fever, meningitis. Late: gummas, neurosyphilis, cardiovascular. more

History of tick bite, erythema migrans, and neurologic findings with constitutional complaints. more

Relapsing fevers, anxiety, psychosis, combative and excitable behaviors, confusion, delirium, depression, catatonia, stupor, coma, decerebrate posturing, death. more

Tapeworm (Taenia Solium) infection of the brain. Ingestion of eggs from pork, infected vegetables. Seizures, headache, parkinsonism, obstructive hydrocephalus, CN palsy, maybe skeletal muscle lesion or visual loss. more

Toxoplasma gondii from infected cat feces. Immunocompetent patient - mild flu like symptoms 1-2 weeks. Immunocompromised patient - encephalitis, cognitive impairment, focal neuro deficit. more

Insidious onset, irregular fever, cough, anxiety, irritability, lethargy, coma. more

Anxiety, depression, fatigue, labile affect, psychosis, impaired cognition, sleep disturbances, ataxia, spasticity, disorientation, delirium, dementia, dysphasia, myoclonus, death. more

Prior history of infection with stupor, coma or nuchal rigidity. Excessive sleeping afterwards. Irritability and anger. Limited attention span. Typical content of thought not marked. more

Symptoms include anorexia, weight loss, myalgia; rheumatoid nodules and small joint deformities, and pain; vasculitis, pericarditis; pleural effusions, pulmonary fibrosis; spinal cord compression, peripheral neuropathy; neuropsychiatric disorders.more

90% are women, more common in Asians and blacks. Photosensitivity, discoid or malar rash, oral ulcers; fatigue, weight loss, fevers; arthralgias and arthritis; pleuritis, pericarditis; renal disease; anemia, leucopenia. more

Widespread pain (typically in all four body quadrants) for at least 3 months and tenderness at 11+ of 18 specific sites on the body. more

Aching and morning stiffness in shoulders, hip girdle, and neck, typically in patients over 50. Also fever, malaise, fatigue, weight loss.more

Classic celiac disease present with signs and symptoms of malabsorption, including diarrhea, steatorrhea, iron-deficiency anemia, and weight loss or growth failure

Nonclassic celiac disease, patients may present with nonspecific gastrointestinal symptoms without signs of malabsorption, or with extraintestinal manifestations (without gastrointestinal symptoms). patients mainly presenting with unexplained iron-deficiency anemia.

Asymptomatic celiac disease - Many patients, especially those diagnosed during screening, report no symptoms even on detailed questioning, and despite the presence of characteristic intestinal lesions. A gluten-free diet often leads to improvement in the quality of life, even in patients who considered themselves asymptomatic at the time of diagnosis. more, symptoms

Depressive symptoms are associated with anemia in a general population of older persons living in the community

Common with certain anticonvulsants (e.g. valproic acid), elderly, alcoholics, eating disorders, malnourished. Symptoms include cognitive dysfunction. Signs - megaloblastic anemia. more

Megaloblastic anemia, myelopathy (subacute combined degeneration), dementia, delirium, peripheral neuropathy. Occurs in pernicious anemia, chronic peptic ulcer disease, after gastrectomy or gastric bypass, alcohol dependence, irritable bowel disorder, eating disorders, malnourished. more

Peripheral neuropathy, seizures, migraines, chronic pain, depression, psychosis. Elevated homocysteine. Many drugs act as antagonists of B6. more

Scurvy: petechiae, ecchymoses, bleeding gums, follicular hyperkeratosis, hemolytic anemia, fatigue, joint effusion, poor wound healing. more

Pellagra: pigmented rash of sun-exposed areas, bright red tongue, diarrhea, apathy, memory loss, disorientation. more

Weakness, fatigue, somnolence, cold intolerance, weight gain, constipation, hair loss, hoarseness, stiffness, muscle aches, bradycardia, facial puffiness, slowed speech. more

Symptoms include nervousness, anxiety, irritability, sweating, fatigue, heat intolerance, weight loss, muscle weakness. Signs include arrhythmias, e.g. atrial fibrillation, myxedema, proptosis. more

Increased thirst, frequent urination. Complications include cardiovascular disease, retinopathy, nephropathy, peripheral and autonomic neuropathy. more

Anorexia, thirst, frequent urination, lethargy, fatigue, muscle weakness, joint pain, constipation. Mild: personality changes, lack of spontaneity, lack of initiative. Moderate: dysphoria, anhedonia, apathy, anxiety, irritability, poor concentration. Severe: confusion, disorientation, agitation, psychosis, lethargy, coma. more

Paresthesias, muscle cramps, carpopedal spasm, rarely facial grimacing, severe - tetany and seizures. more

Anemia, anorexia, nausea, vomiting, diarrhea, abdominal pain, weight loss, muscle weakness. In Addison's disease, increased ACTH causes hyperpigmentation, especially in sun-exposed skin, scars, mucous membranes. Postural hypotension due to low mineralocorticoids; hypoglycemia when stressed or fasting; hyponatremia, hyperkalemia. more

Truncal obesity and striae, diabetes, hypertension, hyperglycemia, muscle weakness, osteopenia, skin atrophy and bruising, increased susceptibility to infections, gonadal dysfunction. Due to use of corticosteroids, excessive ACTH secretion (if by a pituitary tumor, called Cushing's disease), and adrenal tumors. more

Mood symptoms present during the week prior to menses, resolving within a few days after menses starts. Might be accompanied by breast tenderness, muscle aches, abdominal bloating, and weight gain. more

Typical onset is at 51 years. Symptoms include hot flashes, night sweats, palpitations, dizziness, fatigue, headaches, joint pains. more

Amenorrhea or oligomenorrhea, infrequent or absent ovulation, increased levels of testosterone, infertility, truncal obesity or weight gain, alopecia, hirsutism, acanthosis nigricans, hypertension, insulin resistance. more

Increase in rate and depth of breathing for a few minutes leading to dizziness or syncope due to respiratory alkalosis. Also might have carpopedal spasm, myoclonic jerks, paresthesias. more

Multi-system dysfunction, lethargy, altered mental status, seizures. more

Higher risks for dementia in dialysis patients. Need regular dementia work-up. Might have higher risk for vascular dementia, but also associated with uremia. Aluminum toxicity now less common. more, Dialysis disequilibrium syndrome

Abdominal pain, peripheral neuropathy, and mental disturbances. Seizures, autonomic instability, dehydration, electrolyte disturbances, dermatologic changes also may occur. Physical symptoms occur in attacks, but psychological ones may persist. more, more detailed

Onset in childhood and adolescence, but can occur as late as fifth decade. Symptoms include personality and behavioral disturbances, dementia, EPS, dysarthria, liver cirrhosis. Almost all have Kayser-Fleischer rings. more

Multiple episodes; acute onset involving muscle weakness, monocular blindness, vertigo, bladder dysfunction, and incoordination. more

Tremor, bradykinesia, gait disorder, and rigidity. more

Younger age of onset (e.g. 53) than Alzheimer's disease, with prominent lability, distractibility, decrease in insight, and personality changes. more, criteria

Choreoform movements, ocular dysfunction, dementia, and frequent depression with 10% psychosis. more

Uneven cognitive decline, language and visual specific dysfunction. more

Mild extrapyramidal symptoms, sudden changes in cognition, visual hallucinations, rapid eye movement sleep disorder. more

Cognitive decline associated with signs of cortical injury, e.g. aphasia, apraxia, etc. more

Acute global disturbance of cortical functioning that causes fluctuating level of attention, consciousness, cognition, and perception. more

More salient apathy, slowed mentation, and gait dysfunction. more

Supranuclear gaze palsy, especially in vertical direction, truncal rigidity, akinesia, postural instability, early falls, dysarthria, dysphagia; subcortical dementia; pseudobulbar affect. more

Combination of upper motor (weakness, hyperreflexia, spasticity) and lower motor neuron (atrophy, fasciculations) signs. Presents with asymmetric limb weakness (80%) or bulbar disorders of dysphagia or dysarthria (20%). Might be accompanied by pseudobulbar affect, cognitive impairment, autonomic symptoms, parkinsonism, supranuclear gaze paresis, sensory loss. more

Mental retardation, in association with non-neurologic physical abnormalities. more

Tay-Sachs disease (in Ashkenazi Jews) - adult form: clumsiness in childhood, progressive weakness later, followed by motor dysfunction and intellectual decline. more

Cerebellar ataxia, pyramidal signs, and intellectual dysfunction. more

Snoring, daytime sleepiness, awakening with sensation of choking, gasping; restless sleep, nocturia, morning headaches, episodes of breathing cessation, hypertension. more

Chronic daytime sleepiness with episodic sleep attacks; also cataplexy, sleep paralysis, hypnagogic and hypnopompic hallucinations. more

Patients are obese and most have co-existing obstructive sleep apnea (OSA). Many also have pulmonary hypertension with right-sided heart failure. Dyspnea on exertion distinguishes from pure OSA. more

Subjective discomfort of lower extremities and need to move, worse at night. Most idiopathic, but may be associated with iron deficiency, uremia, diabetes, rheumatic disease, venous insufficiency. more

Motor (simple or complex) and vocal tics (sounds or actual words). Starts in childhood. more

Syndrome of prolonged headaches lasting 4 hours or longer. Encompasses constant (transformed) migraines, chronic tension-type headache, medication overuse headache, hemicrania continua, and new daily persistent headache. more

Presence of terminal illness. more

Rule out malignancy. more

Disorder of a body region, usually of the extremities, characterized by pain, swelling, limited range of motion, vasomotor instability, skin changes, and patchy bone demineralization. Frequently begins following an inciting event. more

At least 2 years of depressed mood; may co-exist with MDD. more

Affective lability, depression and/or anxiety as well as neurovegetative symptoms present in the majority of menstrual cycles in the final week before the onset of menses, improving within a few days after the onset of menses, and resolved within a week after menses. more

Emotional response to a stressful event, such as onset of illness, divorce, financial problems. Symptoms start within 3 months of the stressor and remit within 6 months of stressor removal. more

Presence of one or more somatic symptoms that are distressing or result in significant disruption of daily life with excessive thoughts, feelings, or behaviors related to these somatic symptoms. more

Excessive and uncontrollable worry about a number of anxiety-provoking events. more

Characterized by psychotic symptoms as well as presence of manic or depressed episode; psychotic symptoms must exist outside the mood symptoms for at least 2 weeks. more

Dominated by psychotic symptoms of hallucinations, delusions, disorganized thought process, speech, behavior, negative symptoms. Onset typically teens to early 20s in males and late 20s in females. more

In Bipolar I, there must be at least one manic episode. In Bipolar II, there must be presence of hypomanic AND depressive episodes. more, Unipolar v/s bipolar depression

Attenuated bipolar disorder, frequently starts before age 21; frequent short cycles of subsyndromal depression and hypomania, not meeting criteria for bipolar disorder. more

Extreme agitation, delirium, confusion, sleeplessness, hallucinations, delusions with onset usually 3-14 days postpartum. Increased risk for suicide and infanticide

Trauma-associated flashbacks, nightmares, avoidance, hyper-vigilance, and sleep disturbance. more

Demoralized - difficulty in coping with medical illness

 Close temporal association with illness.
Few neurovegetative symptoms.
Able to maintain future orientation/hope		 -Compassion, recognition, and normalization.
-illness-specific supports (groups, social work, chaplaincy)
-Physical therapy (eg, PT/OT).

 

Occurs in response to a significant loss, such as death of loved one. In addition to depressed mood, also have sympathetic arousal and restlessness. Criteria for Major Depressive Episode not met. more

Disaffiliated - grief Few neurovegetative symptoms.
Able to maintain future orientation/hope.
Improvement typical as time since loss increases

-Supportive therapy

-Spiritual support
“Difficult” - patients
have a breakdown
in the therapeutic
alliance with their
treatment team		 Mood changes often
intense, immediate, and
reactive to situation.
Frequent breakdowns in
communication with care
team. Care team more
distressed by patient’s
symptoms than the patient

-Frequent communication
among care team members

-Multidisciplinary care conferences
to clarify salient issues

-Provide patients
with consistent information and
expectations