Psychosis Flashcards
What is psychosis
Clinical state of mind characterised by loss of contact with reality.
Pt may experience perceptual disturbances eg hallucinations
As well as disturbances of thought eg delusions
Causes of Psychosis
Functional psychosis is due to :
-Schizophrenia
-Bipolar Mood Disorder
Psychotic disorders due to medical conditions e.g
Epilepsy, Alzheimer’s dementia, HIV, Neurosyphilis Or
Drugs(cannabis, mandrax, cocaine, prescribed-steroids, atropine,
Other- PostPartum psychosis
Approach to management of psychosis
Depends on
Aetiology
Onset of the psychosis
Acute management (agitated or acutely disturbed pt)
Goals of therapy is to calm pt down and achieve containment
Antipsychotic and/or benzodiazepine of your choice
Chronic management
Goal of therapy is to prevent relapse of acute psychotic symptoms i.e. delusions, hallucination so as to maintain functionality
Antipsychotic drugs
Supportive psychotherapy for patient and family
What are neuroleptics
Neuroleptics are antipsychotic medications
Used to treat and manage main symptoms of many psychiatric disorders.
What are the classical neuroleptics
Dopamine 2 receptor antagonists
What are atypical neuroleptics
-Dopamine 2 and Dopamine receptor antagonists
-Dopamine 2 and serotonin receptor antagonist
Side effects of the classical Dopamine 2 receptor antagonist
Tendency to cause extrapyramidal side effects
-Parkinsonism
-Distonias (abnormal muscle tone,resulting in muscle spasm&abnormal posture)
-Dyskinesia (involuntarily muscle movement)
-Akathisia (inability to hold still)
Children and adolescents more sensitive than adults
Clinical symptoms of psychosis
Impaired awareness, confusion, disorientation
Others: Restlessness, agitation, hallucinations, CNS symptoms, aggressiveness
What are the indications for neuroleptics
Schizophrenia
Mania
Organic psychosis
Others: intractable hiccups
Nausea and vomiting
Behaviour disorders
Anaesthesia
Tourette’s syndrome (nervous system disorder involving repetitive movements or unwanted sounds)
