psychiatric emergencies Flashcards
(11 cards)
What is serotonin syndrome
high synaptic concentration of serotonin
What causes serotonin syndrome
caused by multiple drugs, mc co-administration of antidepressants
* SSRI/ SNRI
* TCA
* MAOi
* Lithium
Describe the classic triad of serotonin syndrome
- neuromuscular abnormalities - hyperreflexia, muscle rigidity, tremor, clonus
- altered mental state - agitation, confusion
- autonomic dysfunction - HTN, hyperthermia, tachycardia
How is serotonin syndrome managed
Medical emergency if severe
* stop causative drugs
* supportive treatment - IV fluids
* benzodiazepines
* 5HT2 antagonist - cyproheptadine or chlorpromazine
What causes acute dystonic syndrome
typical antipsychotics
Give 4 symptoms of acute dystonic syndrome
sustained muscle contraction
* eyes - oculogyric crisis
* neck - torticollis (twisted)
* jaw - mouth open
* pain and distress
How is acute dystonic syndrome managed
IM procyclidine 5-10mg
Indications for electroconvulsive therapy (ECT)
- treatment-resistant depression,
- catatonic schizophrenia
- severe mania
Contraindication to electroconvulsive therapy
raised intracranial pressure
short term side effects of ECT
- headache
- nausea
- short term memory impairment
- cardiac arrhythmia
long term side effects of ECT
impaired memory
