Psychopharmacology and General Medical Conditions. David A Fohrman, M.D. Question. What percent of your patients with psychiatric complaints have a General Medical Condition (GMC)/and or drug interaction that is causing or exacerbating his or her symptoms? A: 30% B: < 1% C: 60% D: 22%
Psychopharmacology and General Medical Conditions
David A Fohrman, M.D.
What percent of your patients with psychiatric complaints have a General Medical Condition (GMC)/and or drug interaction that is causing or exacerbating his or her symptoms?
B: < 1%
E: none of the above
“I WATCH DEATH”
*medical causes refer to pharmacological, substance induced, general medical, genetic and neurodevelopmental causes of psychiatric symptoms
Urine of patient with Acute intermittent Porphyria: often changes color when exposed to sunlight
Child 8 years old with VCFS, note: broadening upper portion of his nose.
Medical conditions which may cause or exacerbate symptoms of Psychosis
Most Medical conditions were one of six categories: Genetic Disease, Collagen Vascular Diseases, Endocrinology, Infectious Disease Neurology, or Toxicology
paresthesias, headaches, ataxia, dysarthria, visual field constriction
Acrodynia: (painful extremities) pink discoloration of hands, feet
31 year old woman with chronic paranoid shizophrenia
Treated with olanazapine (zyprexa) 20mg/day
Developed symptoms of flank pain, fevers
Diagnosis of pyelonephritis
Started on ciprofloxacin, 500mg bid for 7 days
By day 4, pt with inceased stiffness, increased sedation, postural tremor and constipation
Decrease dose of olanazapine to 10mg until finish dose of ciprofloxacin