Psychosis management

Question 1

When is emergency detention viable?

Answer 1

When it is urgent to detain a patient to permit a full assessment of the mental state of the patient, and when where there would be risk to others or themselves if they were not detained

Question 2

How long does emergency detention last?

Answer 2

Max 72 hours

Question 3

How long can a short term detention last?

Answer 3

Max 28 days

Question 4

What considerations must be made before a short term detention can be carried out?

Answer 4

• Patient has mental disorder
• Ability to make decisions based on medical treatment is impaired
• Necessary detention to figure out treatment required

Question 5

How long does a compulsary treatment order last?

Answer 5

max 6 months

Question 6

First line treatment when history unknown

Answer 6

Oral Lorazepam

If unsuccessful

IM Lorazepam

Question 7

Treatment in confirmed history of significant typical antipsychotic exposure?

Answer 7

Oral Lorazepam +/- Haloperidol

Unsuccessful

IM Lorazepam, extreme cases add Haloperidol

Question 8

If sedation is required which drugs should be used?

Answer 8

Benzodiazepens

Or use sedating antipsychotics eg Olanzapine

Question 9

Which antipsychotic is indicated in resistant illness?

Answer 9

Clozapine