Acute Psychiatric Management

Contents
Foreword  02
Introduction  02
SECTION 1 – ASSESSMENT
Comprehensive approach to risk assessment  04
Psychiatric assessment after self-harm  12
The psychiatric assessment of Aboriginal
and Torres Strait Islander peoples  16
Psychopathology in the general medical setting  18
Psychosis in the Medically Ill  21
Gay, Lesbian, Bisexual, Transgender & Intersex
(LGBTI) patient assessment & healthcare provision  22
SECTION 2 – TREATMENTS
Long acting injectable antipsychotics  26
Lithium therapy  30
Clozapine  32
Anticonvulsant medications in psychiatry  36
Psychotropic drugs in pregnancy and breastfeeding  39
Electroconvulsive Therapy (ECT)  42
Pro Re Nata (PRN) medication  45
SECTION 3 – MANAGEMENT CHALLENGES
Acute management of physical aggression  50
Acute management of alcohol and benzodiazepine
withdrawal syndromes  54
The management of opiate withdrawal & dependence 58
Recognition and management of delirium  68
Neuroleptic Malignant Syndrome  74
The Serotonin Syndrome  76
SECTION 4 – COMPLICATIONS
Metabolic complications of antipsychotic treatment  80
QTc abnormalities and psychotropic treatment  83
Akathisia and tardive dyskinesia  86
Hyperprolactinaemia  89
SECTION 5 – IMPORTANT LEGISLATION
The Mental Health Act (2007)  94
The Commonwealth Privacy Act  97
The Guardianship Act  98
Capacity as a legal construct in mental health care  101