Hypokalemia and agitation in acute psychotic patients

Hypokalemia is caused partly by intensive exercise. Some evidence suggests that psychological distress may cause hypokalemia. The relationship between the decline of serum potassium concentration and the level of symptoms of acute agitation, which was defined as a total score on a subset of six cate gories on the 18-item Brief Psychiatric Rating Scale (anxiety, tension, man nerism and posturing, hostility, uncooperativeness, psychomotor excitement) , was examined in 313 schizophrenic men, admitted on an emergency basis dur ing a 24-month period. In addition, change in serum potassium concentration after sedation was investigated. Serum potassium concentration in the seve rely agitated group was lower than that in the mild,group. There was a sign ificant correlation between serum potassium concentration and the level of symptoms of acute agitation (r = -0.30, P < 0.0001). Although the decline o f serum potassium concentration in the patients who were sufficiently sedat ed improved within 8 h, that in the patients showing high scores on the acu te agitation subset even 8 h after emergency admission was prolonged. Resul ts indicate that sedation improves acute agitation-induced hypokalemia. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.