RESUMO
With the availability of newer, safer antidepressants in the past decade, initiation of definitive treatment for depression in the emergency setting has become an accepted practice. However, the use of newer antidepressants and atypical antipsychotics in depression complicated by psychosis or agitation has not yet been well studied. This article will review relevant data and make recommendations for the emergency management of psychotic and agitated depressive syndromes.
Assuntos
Antidepressivos/uso terapêutico , Antipsicóticos/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Serviços de Emergência Psiquiátrica , Agitação Psicomotora/tratamento farmacológico , Transtornos Psicóticos/tratamento farmacológico , Adulto , Antidepressivos/administração & dosagem , Antipsicóticos/administração & dosagem , Comorbidade , Delusões/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Quimioterapia Combinada , Feminino , Alucinações/tratamento farmacológico , Humanos , Agitação Psicomotora/epidemiologia , Agitação Psicomotora/psicologia , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologiaRESUMO
Mood and anxiety disorders are common in the general population and in the emergency setting. As psychiatric emergency care moves from the realm of triage and referral to a more definitive initiation of treatment, clinicians must approach the assessment and initial management of patients with mood and anxiety disorder in a rational and safe way. In the ED, the next step in assessing patients with mood or anxiety symptoms, after any immediate safety concerns are addressed, is to rule out medical or substance-induced causes. Treatment of these patients is directed at the underlying condition. When a primary psychiatric diagnosis is made, initial management, including definitive pharmacologic or psychotherapeutic intervention, can be started in the ED.
