Refining medical clearance protocol for patients with primary psychiatric complaints in the emergency department
DiscussionOur results support the recommended guidelines set by AAEP for laboratory testing in addition to history, vital signs and physical examination prior to medical clearance. Certain laboratory testing such as CK and CMP were identified to have higher utility for medical intervention while other lab work such as UA and UDS had less of an impact. Further, we suggest that specifically a CK and CMP be obtained on patients presenting with any of the following: agitation, abnormal vital signs, intoxication, or a history of or current stimulant use as these were factors correlated with lab abnormalities that led to interve...
Source: Frontiers in Psychiatry - July 10, 2023 Category: Psychiatry Source Type: research
Sublingual lorazepam as rescue therapy for seizure emergencies in adults
Epilepsy Behav. 2023 Jul 3;145:109294. doi: 10.1016/j.yebeh.2023.109294. Online ahead of print.ABSTRACTOBJECTIVE: Limited acute home treatments are available for patients with prolonged (>5 minutes) or repetitive (≥2 in 24 hours) seizures. While this early seizure treatment may reduce the need for emergency care, intermittent intranasal benzodiazepine formulations are expensive and rectal diazepam administration is often socially unacceptable. We determined whether caregivers could use sublingual lorazepam oral concentrate solution effectively as acute treatment for adults with prolonged and repetitive seizures.METHOD...
Source: Epilepsy and Behaviour - July 5, 2023 Category: Neurology Authors: Isabella R Lelis Gregory L Krauss Source Type: research
Sublingual lorazepam as rescue therapy for seizure emergencies in adults
Epilepsy Behav. 2023 Jul 3;145:109294. doi: 10.1016/j.yebeh.2023.109294. Online ahead of print.ABSTRACTOBJECTIVE: Limited acute home treatments are available for patients with prolonged (>5 minutes) or repetitive (≥2 in 24 hours) seizures. While this early seizure treatment may reduce the need for emergency care, intermittent intranasal benzodiazepine formulations are expensive and rectal diazepam administration is often socially unacceptable. We determined whether caregivers could use sublingual lorazepam oral concentrate solution effectively as acute treatment for adults with prolonged and repetitive seizures.METHOD...
Source: Epilepsy and Behaviour - July 5, 2023 Category: Neurology Authors: Isabella R Lelis Gregory L Krauss Source Type: research
Beyond benzodiazepines: a meta-analysis and narrative synthesis of the efficacy and safety of alternative options for alcohol withdrawal syndrome management
ConclusionFor AWS treatments, non-BZDs are superior to or equally effective as BZDs. Non-BZD adverse events warrant further investigation. Agents that inhibit gated ion channels are promising candidates.Protocol registrationPROSPERO CRD42022384875. (Source: European Journal of Clinical Pharmacology)
Source: European Journal of Clinical Pharmacology - June 28, 2023 Category: Drugs & Pharmacology Source Type: research
Serotonin Syndrome with Monotherapy of Low-Dose Sertraline in an Adult Patient with Autism Spectrum Disorder
We present a case of a 32-year-old male with a history of autism spectrum disorder and depressive disorder who presented to the emergency department with restless agitation, neuromuscular excitability, and autonomic instability. He had been prescribed sertraline 50 mg which he had taken daily as prescribed for 4 days. On the fourth day, he presented to the emergency department with diffuse muscle stiffness, upper extremity tremors, ocular clonus, and inducible ankle clonus. He was diagnosed with probable serotonin syndrome utilizing Hunter's criteria. Patient's symptoms resolved within 24 hours with intravenous fluids, lor...
Source: Case Reports in Psychiatry - June 16, 2023 Category: Psychiatry Authors: Rohit Madan Jody Platto Senthil Rajaram Manoharan Varun Monga Source Type: research
