Psychopharmacology in the Emergency Department

Psychopharmacology in the Emergency Department 

As a healthcare provider in an emergency department, you may serve patients who present with symptoms indicative of a behavioral health disorder, such as depressive disorder, bipolar disorder, and anxiety disorder. In some situations, it is necessary for the emergency department provider to administer psychiatric medications to the patient, while in others it is prudent to defer their use until the patient is either admitted to an inpatient mental health facility or seen as an outpatient. In many instances, the reason for presentation in the emergency department is an adverse reaction to a psychiatric medication, and it is important for the emergency department provider to understand how to recognize these adverse reactions and to treat them. In this course, you will learn about the major categories of medications used in the treatment of mental health disorders, including antipsychotics, antianxiety medications, antidepressants, and mood stabilizers. You will also learn about the different medications’ indications for use and some of their most common adverse side effects. You will find out about some of the special precautions that apply to special populations taking psychiatric medications, such as older adults and pregnant and nursing patients. You will also learn the major adverse reactions produced by psychiatric medications that are often seen in an emergency department setting. This course is intended for all emergency department personnel and providers.


Hours: 1.50


Certificates provided by accrediting body (0 Match)

Course Details

Course Code: REL-PI-0-P24
Hours: 1.5
Type: Online Course
Content Expiration Date: 1/31/2021
Learning Objectives:
Describe the major categories of medications used to treat mental health disorders and their adverse side effects.
Discuss some of the most common medications in each major category, their indications, as well as their usage in the treatment of mental health disorders.
Explain the special concerns related to use of psychotherapeutic medications in older adults and pregnant and nursing patients.
Diagnose and treat adverse reactions to psychotropic medications that present to the emergency department.

Section 1: Introduction A. Disclaimer B. About This Course C. Learning Objectives Section 2: Psychiatric Medications A. Jacob and Janice B. How Medications Work C. Categories of Psychiatric Medications D. Different People, Different Results E. Factors Affecting Medication F. FDA Approval and Off-Label Use G. What to Tell Patients About Medications H. Section Summary Section 3: Antipsychotic Medications A. Psychotic Disorders B. Symptoms of Psychotic Disorders C. Antipsychotic Medications D. First-Generation (Typical) Antipsychotic Medications E. Common FGA Adverse Side Effects F. Second-Generation (Atypical) Antipsychotic Medications G. Other SGAs H. Treating Acute Psychosis with Antipsychotic Medication I. Neuroleptic Malignant Syndrome J. Case Study: Bruno K. Section Summary Section 4: Mood Stabilizer Medications A. Bipolar Disorder B. Bipolar I and Bipolar II C. The Depressive Pole D. Bipolar Symptoms in the ED E. Lithium F. Treating Bipolar Disorder with Lithium G. Common Side Effects of Lithium H. Lithium Toxicity I. Valproate for Bipolar Disorder J. Other Anticonvulsants for Treating Bipolar Disorder K. Antipsychotic Drug Mood Stabilizers L. Multiple Medications for Bipolar Disorder M. Case Study: Sarah N. Section Summary Section 5: Antidepressant Medications A. Signs of Depression B. The Many Faces of Depression C. Antidepressants D. Antidepressants’ Full Effects E. Antidepressant Dosages F. Tricyclic Antidepressants G. Interactions with MAOIs H. SSRI Antidepressants I. Other Types of Antidepressants J. Side Effects of Tricyclic Antidepressants K. Side Effects of Newer Antidepressants L. Serotonin Syndrome M. MAOI Hypertensive Crisis N. Withdrawal from Antidepressants O. Hyponatremia and SIADH P. FDA Warnings and Antidepressants Q. Meet Amy R. Section Summary Section 6: Antianxiety Medications A. Anxiety B. Antidepressants for Anxiety and Related Disorders C. Review D. Benzodiazepines E. ED Use of Benzodiazepines F. Withdrawal and Misuse G. Benzodiazepine Overdose H. Other Medications for Anxiety I. Meet Luiz J. Section Summary Section 7: Medication Use in Special Populations A. Special Populations B. Older Adults C. Antipsychotic Medications and Dementia D. Pregnancy and Birth Control Precautions E. Let’s Review F. Section Summary Section 8: Conclusion A. Summary B. Congratulations! C. Course Contributors D. References

Instructor: Jack M. Gorman, MD

Jack M. Gorman, M.D. co-founded Critica Inc, a non-profit corporation, with his daughter, Dr. Sara Gorman, in 2016 and is its President and Chair. Critica is devoted to fighting science denial and promoting the acceptance of science in health and safety decision-making.

Before founding Critica, Dr. Gorman was Chief Scientific Officer and Senior Vice-President of both Comprehensive NeuroScience Inc and Care Management Technologies Inc. Dr. Gorman is co-editor of the textbooks Treatments that Work, now in its fourth edition, and Comprehensive Textbook of AIDS Psychiatry, now in its second edition, and author of the popular book The Essential Guide to Psychiatric Drugs, which appeared in its fourth edition in 2007. With his daughter, Dr. Sara Gorman, he wrote Denying to the Grave, on the reasons behind denial of scientific medical evidence, published by Oxford University Press in 2016. It has been discussed in media throughout the world. His newest book, Neuroscience at the Intersection of Mind and Brain, was published in 2018.

Disclosure: Jack M. Gorman, MD has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Christopher Reist, MD, MBA
Dr. Reist is an Associate Professor (with tenure) in the Department of Psychiatry and Human Behavior at the University of California, Irvine. He also serves as Assistant Dean in the College of Medicine and the Director of Medical Research for the Long Beach Veterans Affairs Healthcare System. Formerly, he served as Chief of Mental Health, overseeing full service mental health care delivery to over 40,000 enrollees at the Long Beach VA Healthcare System. For the past 12 years, he has served as Associate Director of the Southern California VA Mental Illness Research, Education, and Clinical Center (MIRECC), which is focused on improving long-term outcomes in chronic psychotic disorders through basic/clinical research and dissemination of evidence-based practices. Dr. Reist’s clinical interests include schizophrenia, impulsivity, PTSD, pharmacogenomics, and psychopharmacology. NARSAD, NIMH, and VA Medical Research have supported his research. He has served as principal investigator on over 25 clinical trials in areas including schizophrenia, depression, bipolar disorder and impulsivity. He is a member of professional societies, including the American Psychiatric Association, Pacific Rim Association for Clinical Pharmacogenetics, and the Society of Biological Psychiatry. He is a Distinguished Fellow of the Psychiatric Association, has been recognized as an Exemplary Psychiatrist by the National Alliance for the Mentally Ill, and is included in Best Doctors 2007-2010. He is the author of two books, Psychiatry and Psychiatric Drugs, which have been widely used by trainees for the past 15 years. He has over 50 scientific articles that have been published in high-impact journals, including Molecular Psychiatry, Biological Psychiatry, Journal of Clinical Psychiatry, American Journal of Psychiatry, and Nature Biotechnology. Lastly, he has extensive experience in psychiatric education that include organizing CME conferences and developing web content that provide information on psychiatric disorders and treatment. Disclosure: Christopher Reist, MD, MBA discloses the following potential conflict of interests/commercial interests: Relevant Financial Relationship with Alkermes as Grant/Research Support
Target Audience:
The target audience for this course is: Entry, Intermediate level Physicians; Nurses; in the following settings: Acute Care Facility.
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Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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