World Delirium Awareness Day and QTc Prolongation Update

Today is World Delirium Awareness Day! And this is also National Patient Safety Awareness Week! Here's an issue relevant to both. As a psychiatric consultant in the general hospital, I get questions from colleagues about psychotropic drugs and cardiac conduction prolongation, often measured by the EKG parameter called the corrected QT interval or QTc. Relevant … Continue reading World Delirium Awareness Day and QTc Prolongation Update

Delirium and the EEG Revisited: Blog Post by Medical Student Terrence Wong

https://www.youtube.com/watch?v=ijGRkGEPL9o I've got a sharp medical student, Terrence Wong, on my team who is participating in a new delirium detection study headed by one of my colleagues, Dr. Gen Shinozaki, MD working with surgeon Dr. John Cromwell, MD on using a simplified EEG procedure to detect delirium. It just might help move the clouds away from … Continue reading Delirium and the EEG Revisited: Blog Post by Medical Student Terrence Wong

Treating Agitation of Delirium with Valproic Acid and Climbing Mt. Everest Alike?

https://www.youtube.com/watch?v=pSg5NNgHkXQ I saw the a summary of Dr. Yelizaveta Sher's study evaluating the use of valproic acid for treating hyperactive delirium.  I think it's an interesting approach. It was presented at a recent Academy of Psychosomatic Medicine meeting. This led to my clicking around the internet in search of further literature about it. I'm always looking … Continue reading Treating Agitation of Delirium with Valproic Acid and Climbing Mt. Everest Alike?

Clozapine in the General Hospital

I occasionally get questions from my colleagues on general medical and critical care units about how to order clozapine, a second-generation antipsychotic for patients with treatment resistant schizophrenia. It's a difficult drug to use because of its many side effects and the need to titrate it carefully. This is by no means an exhaustive review … Continue reading Clozapine in the General Hospital

CPCP: Drugs for Delirium by Rock Star Residents and A Medical Student

http://www.youtube.com/watch?v=-Ux3-a9RE1Q We heard a great Clinical Problems in Consultation Psychiatry (CPCP) presentation from rock star residents Thomas Salter, Paul Thisayakorn as well as medical student Rick Siel.  Tom and Paul took the lead in making the slides. The topic was psychopharmacology for agitation of delirium. I wish I could have found pictures for all of … Continue reading CPCP: Drugs for Delirium by Rock Star Residents and A Medical Student

Reflections on the “Ban Haldol?” Poll So Far

Well, it's been a little over a month since I posted the poll asking readers whether or not they'd ban the antipsychotic haloperidol for managing agitation in delirious patients hospitalized on intensive care units (ICUs). And most of the time, a majority of voters would choose not to ban the antipsychotic. See the original post for a review of the … Continue reading Reflections on the “Ban Haldol?” Poll So Far

Delirium and PTSD from the ICU Experience

Nightmares After the I.C.U. - NYTimes.com Diaries Aid Mental Recovery - NYTimes.com I just recently read the two New York Times articles above about delirium and Post-traumatic Stress Disorder (PTSD) in patients hospitalized in intensive care units (ICUs). They are compelling stories of people who may suffer what can be the terror of being in … Continue reading Delirium and PTSD from the ICU Experience