emDocs - August 13, 2018 - Authors: Zentko P and Hahn C
Edited by: Koyfman A and Long B
"Pearls
- Psychotropic drugs have multiple potential adverse effects. Take a moment to consider what drugs a patient takes at home and what you offer them in the ED.
- Citalopram and Escitalopram are different from other SSRIs; beware of seizures and QT on EKG.
- Use caution when administering medications with renal effects to someone taking lithium.
Pitfalls
- Failure to take a thorough medication history in patients taking psychotropic drugs.
- Not considering that lithium is primarily renally excreted.
- Failing to obtain an EKG for a chemically sedated patient when multiple doses of antipsychotics are given (or when the patient is known to be taking a QT prolonging agent).
- Failing to consider serotonin syndrome or neuroleptic malignant syndrome in the ill appearing patient on psychotropic drugs."