Drug-Induced Neurological Syndromes Characteristic Neuroleptic Malignant Syndrome (NMS) Central Anticholinergic Syndrome Serotonin Syndrome Malignant/Lethal Catatonia Malignant Hyperthermia Risk factors Rapid increases and high doses of antipsychotic medication IM antipsychotic use…
Drug Overdose General Considerations Important to recognize overdose, but overdose is properly treated in the emergency department by a medical team. Because several drugs are slowly absorbed, the minimal time…
Use of Psychotropics in Breastfeeding General Principles Perform a thorough evaluation, including maternal psychiatric history. Perform risk-benefit analysis (of mother and infant) to determine need for medication, keeping in mind…
Psychotropic Management in Pregnancy Critical Phases in Normal Development Risk of termination if toxicity occurs prior to implantation. Prior to placenta formation, developing embryo likely not exposed to drugs. Weeks…
Postpartum Disorders Postpartum Blues Postpartum Depression Postpartum Psychosis Prevalence 50%-85% 10% of women who give birth 25% of postpartum women with history of major depression—risk further increased with intrapartum onset…
Malingering Differential Diagnosis of Malingering DSM-IV-TRa Diagnosis or Condition Intentional Production of Symptoms Clinical Features Conversion disorder No Voluntary or motor sensory deficits not explainable by a neurological or general…
Electroconvulsive Therapy General Considerations Uses an electrical current to depolarize the brain, inducing a generalized seizure. Mechanism of action unclear. Positive predictors include increasing age, sudden onset and short duration…
Substances of Abuse Substance Intoxication Signs and Symptoms Distinguishing Characteristics of Intoxication Urine Toxicologya Withdrawal/Chronic Use Amphetamines AKA Crank Speed Fast onset, usually within an hour. Physical: mydriasis, anorexia, insomnia,…
Psychotropic-Induced Movement Disorders Movement Disorder Mechanism Onset Clinical Features Management Akathisia An imbalance between the noradrenergic and dopaminergic systems caused by the dopamine receptor antagonists. Days to weeks Subjective feeling…
Benzodiazepine Withdrawal Guidelines for Treatment of Benzodiazepine Withdrawal1 Evaluate and treat concomitant medical and psychiatric conditions. Obtain drug history and urine and blood sample for drug and ethanol assay. Determine…
