Psych Emergencies

Question 1

Life-threatening complication of antipsychotic treatment.

Mortality 10-20%

Answer 1

Neuroleptic Malignant syndrome

Question 2

Can be precipitated in Parkinson’s after abrupt withdrawal of dopamine precursor levodopa

Answer 2

Neuroleptic malignant syndrome

Question 3

Can occur at anytime during treatment with antipsychotic. Presents with muscular rigidity. Dystonia, akinesia (loss of voluntary movement), mutism, agitation, and obtundation

Answer 3

Neuroleptic malignant syndrome

Question 4

HIGH fever, diaphoresis (sweating), hypertension, tachycardia

Answer 4

Neuroleptic malignant syndrome

Question 5

INCREASED CK and INCREASED liver enzymes.

Can progress to rhabdomyolysis and renal dysfunction

Answer 5

Neuroleptic malignant syndrome

Question 6

Stop offending med.

Give dantrolene, bromocriptine, or amantadine

Answer 6

Neuroleptic malignant syndrome

Question 7

Delerium, agitation, tachycardia, diaphoresis (sweating), and diarrhea.
MYOCLONUS AND HYPERREFLEXIA.
Hyperthermia, seizures, rhabdo, renal failure, cardiac arrhythmias, DIC

Answer 7

Serotonin syndrome

Question 8

Stop offending med and supportive care.

Give serotonin antagonist or cyproheptadine

Answer 8

Serotonin syndrome