Herbals and Dietary Supplements
Herbals and Dietary Supplements General Considerations Herbal agents are considered food supplements, and safety, optimal dosing, and efficacy do not have to be established. As herbal agents are not subject…
Suicide Assessment and Management
Suicide Assessment and Management Suicide Risk Factors Demographic Findings on History Examination Findings Protective Male gender White Single/not married Age Homosexual/bisexual orientation Unemployed History of present illness Presence of suicidal…
Physical Health Monitoring for Psychotropic Medications
Physical Health Monitoring for Psychotropic Medications Mood Stabilizers Lithium Test Baseline Weekly for 4 Weeks Monthly for 3 Months Quarterly Yearly When Symptoms Arise Special Considerations Pregnancy test X X…
Drug-Induced Neurological Syndromes
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
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
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
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 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
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
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…
