Psychosis and Mania

Qs

What medications other than antipsychotics can be useful in agitation?

SSRI - citalopram for patients with dementia

Neudexta for patients with dementia

What distinguishes delirium from secondary mania?

• Waxing and waning course

• decreased arousal

• Clouded consciousness

Note both have abrupt onset.

What are endocrine medical illness that can lead to secondary mania?

• Hyperthyroid

• Cushing syndrome ( high ACTH→high cortisol→mood disturbance)

Which patient population have the highest incidence of catatonia?

Patients with medical illness (4-46%)

Which infections should also be considered for patients in hospital with acute psychosis?

• Neurosyphillis

• HIV

• HSV

Which endocrine d/o can also lead to psychosis?

• Thyrotoxcosis

• Postpartum thyroiditis

• Hypothyroidism (myxedema maddness)

• addison’s

• Cushing’s

• Hyper and hypoparathyroidism

• Hypoglycemia

What kind of epilepsy can lead to psychosis ?

Mostly temporal lobe but frontal may as well

Which neurodegenerative diseases are more likely to present with secondary mania?

• FTD

• Huntingtons

• Wilsons

• Fahrs disease

• Postencephalatic parkinsons

What are the most common medical issues and medication know to cause catatonia?

• infectious diseases

• metabolic causes

• seizures

• Disulfram

• Antipsychotics

• PCP

• Corticosteroids