Pediatric emergency medicine trisk 4204 4204
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and delusions) and a decreased likelihood of EPS and long-term tardive
dyskinesia.
The major acute side effects of typical antipsychotic medications are EPS,
including acute dystonic reactions (abnormal muscle tone or posturing),
akathisia (motor restlessness), and parkinsonian effects (rigidity, tremor,
slowed movement, and loss of balance). Acute dystonic reactions are best
treated by PO, intravenous, or IM administration of diphenhydramine (25 to
50 mg) or PO or IM administration of benztropine (1 to 2 mg per day).
SOMATIC SYMPTOM AND RELATED DISORDERS
Goals of Treatment
In the DSM-5, disorders previously classified as “Conversion” or
“Psychosomatic” disorders have been reclassified and renamed. The goals of
emergency treatment of these disorders are to assess for underlying
emergent/common medical etiologies, limit unnecessary medical workup
and treatment as much as possible, identify possible contributing stressors,
provide the family and patient with empathic, supportive, and therapeutic
information about the psychological contributors to the patient’s symptoms,
and to provide appropriate referrals and guidance about how families can
best support the patient’s return to function.
CLINICAL PEARLS AND PITFALLS
