Psychiatric Emergencies

Question 1

What is Neuroleptic Malignant Syndrome and what are the symptoms?

Answer 1

Reaction to a new antipsychotic or neuroleptic.
Hyperthermia, severe muscle rigidity, autonomic instability (tachycardia, increased BP, tachypnoea, sweating), fluctuating consciousness, rigid muscles.
Increased creatinine phosphokinase

Question 2

What is the treatment for Neuroleptic Malignant Syndrome?

Answer 2

ABC, stop antipsychotic, fluid balance, supportive management.

Question 3

What is Serotonin Syndrome and what are the symptoms?

Answer 3

Occurs rarely with the use of serotonergic drugs.

1. Autonomic - fever, sweats, rigors, tachycardia, diarrhoea
2. Cognitive - headache, agitation, confusion, LoC
3. Neuro - tremor, hyperreflexia, myoclonus

Question 4

What is the treatment for Serotonin Syndrome?

Answer 4

ABC, stop precipitating drugs, supportive management.