Abnormal Involuntary Movement Scale (AIMS),53, 185–187, 190Absolute neutrophil count (ANC),21. See also Agranulocytosis, with clozapine and other psychotropic medicationsAcetaminophen + hydrocodone, combined with opioids,31Acetazolamide, TD and,189Acetylsalicylic acid + oxycodone, combined with opioids,31Acid. See Lysergic acid diethylamideAcute dystoniaassessment of,4–6culprit medications and,3–4follow-up management of,7induced by psychotropics,8management of,6–7manifestation of,2, 8mechanism of action of,1, 8medication-induced,3overview,1–3reactions to,1recognition and detection of,3risk factors for,2–3, 8second-line therapy for,6–7sudden death and,4symptoms of,4–6treatment of,6–7, 8Addictionculprit substances and medicationscannabinoids,172–173ethanol,168–170nicotine and cigarette smoking,173–175psychedelics,175–176stimulants,170–172follow-up management of,176overview,167ADEs (adverse drug events),125. See also Polypharmacy, acute side effects ofADH (antidiuretic hormone),81. See also Hyponatremiaβ-Adrenergic-blocking agents, stimulants and,171Adverse drug events (ADEs),125. See also Polypharmacy, acute side effects ofAge. See ElderlyAgitated Behavior Scale,16Agitationassessment of,15–16culprit medications and,11–15antidepressants,11–12antipsychotics,12–13benzodiazepines,14mood stabilizers,13–14nonbenzodiazepine receptor agonists,14description of,11follow-up management of,17management of,16–17overview,11recognition and detection of,11Agomelatine, discontinuation of,55Agranulocytosis, with clozapine and other psychotropic medicationsassessment of,24–25clinical setting for,24complete blood count,24–25, 26initial evaluation of,24culprit medications,22–24anticonvulsants,23antidepressants,23mood stabilizers,23definition of,21etiology and pathogenesis of,23–24fatality rate of,21, 22, 25follow-up management of,25–26incidence of,21–22infection and,25management of,25overview,21–22presentation of,24psychoeducation about,26recognition and detection of,22risk factors for,26stabilization of,25AIMS (Abnormal Involuntary Movement Scale),53, 185Akathisia, antipsychotic-induced,16Alanine transaminase (ALT),64Alcohol, addiction to,168Alcohol use disorder,14disulfiram for treatment of,169Alprazolamcombined with opioids,31risk of seizures with,151ALT (alanine transaminase),64Amantadine, NMS and,93American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults,82, 83, 126, 129, 131. See also Polypharmacy, acute side effects ofAmitriptylineBrugada syndrome and,41ethanol and,168hepatotoxicity and,64nicotine and,173Amoxapine, agranulocytosis and,23Amphetaminesaddiction to,170coronary vasospasm and,48during pregnancy,139serotonin syndrome and,159ANC (absolute neutrophil count),21. See also Agranulocytosis, with clozapine and other psychotropic medicationsAngiotensin converting enzyme inhibitorsfor management of myocarditis,46for management of noninflammatory cardiomyopathy,47Antibiotics, serotonin syndrome and,159Anticholinergic Cognitive Burden Scale,127Anticholinergicsanticholinergic burden,127muscarinic receptors,126NMS and,93polypharmacy, acute side effects of,126–127Anticonvulsant medicationsagranulocytosis and,23discontinuation of,54–55assessment of,54management of,54–55recognition and detection of,54Antidepressantsagitation and,11–12agranulocytosis and,23as cause of SIADH or hyponatremia,83–84, 88discontinuation of,55–57assessment of,56brain zaps and,55follow-up management of,57management of,56–57persistent postwithdrawal disorder,56rebound symptoms,56withdrawal symptoms,55–56hepatotoxicity and,64–65intentional overdose of,117overdose of,122during pregnancy,140risk of seizures with,149Antidiuretic hormone (ADH),81. See also HyponatremiaAntiemeticsacute dystonia and,4NMS and,93Antiepileptic drugsanticholinergic effects and,126–127as cause of SIADH or hyponatremia,84–85, 88during pregnancy,142Antihistamines, anticholinergic effects and,126–127Antihypertensive agents, for management of serotonin syndrome,163Antimuscarinic drugs, for management of antipsychotic overdose,120Antiparkinsonian drugsanticholinergic effects and,126–127withdrawal and NMS,93Antipsychotic medicationsagitation and,12–13anticholinergic effects and,126–127as cause of SIADH or hyponatremia,83, 85, 88delirium and,13discontinuation of,52–53assessment of,53follow-up management of,53management of,53recognition and detection of,52persistent postwithdrawal disorder,52rebound symptoms,52withdrawal symptoms,52ethanol and,169extrapyramidal side effects of,119nicotine and,173–174polypharmacy, acute side effects of,128–129during pregnancy,139risk of seizures with,150–151TD and,187Antivirals, serotonin syndrome and,159Anxietyassociated with bupropion,12opioids and,35in women,135Anxiolytics, risk of seizures with,151Apgar scores,143Aripiprazoleacute dystonia and,4oculogyric crisis and,105toxicity from,121Asymptomatic alanine transaminase (ALT),64Atomoxetine, during pregnancy,139Atrioventricular (AV) blockassessment of,44culprit medications,44description of,43follow-up management of,45management of,44recognition and detection of,43–44types of,43Atypical antidepressants, agitation and,12AV. See Atrioventricular blockAvanafil, visual disturbances related to,107–108BaclofenNMS and,93TD and,189Barbiturates, ethanol and,169Barnes Akathisia Rating Scale,16Benzodiazepines,116–117agitation and,14as allosteric modulators,127AV block and,44in combination with opioidsassessment of,31–32culprit medications,31follow-up management of,35incidence,29–30management of,32–35overview,29–30recognition and detection of toxicity,30–31discontinuation of,57–59, 162–163assessment of,58follow-up management of,59management of,58–59overview,57recognition and detection of,57–58persistent postwithdrawal disorder,58rebound symptoms,58withdrawal symptoms,57–58dosage,36ethanol and,169false-negative tests for,33–34flexible tapers for,34hepatotoxicity and,68for management of acute dystonia,6–7methadone and,31NMS and,95ocular side effects of,103polypharmacy, acute side effects of,127–128during pregnancy,139–140risk factors and,34, 36risk of seizures with,151stable, low-dose therapy,31for treatment of serotonin toxicity,123Benztropinefor follow-up management of acute dystonia,7for management of acute dystonia,6for management of antipsychotic overdose,120for management of oculogyric crisis,105Bipolar depressionpramipexole for treatment of,14relapse of,55β-BlockersAV block and,44for management of myocarditis,46for management of noninflammatory cardiomyopathy,47Blue tinge,107Botulinum toxin type A, TD and,189Bradykinesia,119Brain zaps,55Bromocriptinefor management of antipsychotic overdose,120NMS and,95TD and,189Brugada syndromeassessment of,42culprit medications,41description of,41follow-up management of,42management of,42recognition and detection of,41Buccolingual crisis,4Bupropionaddiction to,170associated with anxiety,12AV block and,44as cause of SIADH or hyponatremia,84, 87discontinuation of,55ethanol and,168hepatotoxicity and,64, 65nicotine and,173overdose of,116during pregnancy,137risk of seizures with,149, 152Bush-Francis Catatonia Rating Scale,16Buspironerisk of seizures with,151serotonin syndrome and,159TD and,189Butyrophenones, oculogyric crisis and,105Caffeine, risk of seizures with,152Calcium channel blockersAV block and,44for management of coronary vasospasm,48Cannabidiol (CBD),172Cannabinoids, addiction to,177assessment of,173management of,173recognition and detection of,172CannabisBrugada syndrome and,41coronary vasospasm and,48Carbamazepineagitation and,12–13agranulocytosis and,23AV block and,44Brugada syndrome and,41as cause of SIADH or hyponatremia,83, 84–85, 88discontinuation of,54ocular side effects of,103oculogyric crisis and,105pigmentary retinal deposits and,107during pregnancy,138ventricular conduction delay and,45Cardiac emergenciesatrioventricular block,43–45Brugada syndrome,41–42coronary vasospasm,47–48myocarditis,46–47noninflammatory cardiomyopathy,47overview,39psychiatry and cardiology collaboration for,49serotonin syndrome and,161–162sick sinus syndrome,42–43torsades de pointes,39–41ventricular conduction delay,45Carvedilol, AV block and,44Cataracts. See Pigmentary cataract depositsCatatonia,5–6, 92CBC. See Complete blood countCBD (cannabidiol),172CBT, for management of chronic pain and chronic anxiety,35CDC. See Centers for Disease Control and PreventionCenters for Disease Control and Prevention (CDC),31recommendation guidelines for management of benzodiazepines and opioids,32–35Chlordiazepoxidecombined with opioids,31pigmentary retinal deposits and,107Chlorpromazineacute dystonia and,3hepatotoxicity and,66ocular side effects of,100pigmentary cataract deposits and,106polypharmacy, acute side effects of,129risk of seizures with,150TdP and,40Choreiform movements,92Ciprofloxacin, serotonin syndrome and,159Citalopramassociation with D2 receptor–blocking agents,1AV block and,44hepatotoxicity and,64NMS and,93ocular side effects of,101during pregnancy,136TdP and,40Clevidipine, dosing,78Clomipramineagranulocytosis and,23Brugada syndrome and,41Clonazepamcombined with opioids,31for management of acute dystonia,7risk of seizures with,151TD and,189Clozapine. See also Agranulocytosis, with clozapine and other psychotropic medicationsAV block and,44hepatotoxicity and,66management of toxicity from,174–175myocarditis and,46nicotine and,174NMS and,92noninflammatory cardiomyopathy and,47polypharmacy, acute side effects of,129risk of seizures with,150–151, 152TD and,187Cocaineaddiction to,170Brugada syndrome and,41coronary vasospasm and,48hypertensive crisis and,77serotonin syndrome and,159ventricular conduction delay and,45Codeine, combined with opioids,31Cohen-Mansfield Agitation Inventory Observational Tool,16Complete blood count (CBC), for assessment of agranulocytosis,24–25, 26Coronary vasospasmassessment of,48culprit medications,48description of,47follow-up management of,48management of,48recognition and detection of,48Corticosteroidsfor management of myocarditis,46for management of noninflammatory cardiomyopathy,47Counseling, about risks of in utero medication exposure,141Cycloplegia,101assessment of,104culprit medications,104description of,103–104follow-up management of,104management of,104recognition and detection of,104CYP. See Cytochrome P450CYP2D6 inhibitorsAV block and,44psychedelics and,175serotonin syndrome and,159CYP enzymes, nicotine and,173–174Cyproheptadine, for management of serotonin syndrome,163, 172Cytochrome isoform 2D6,65Cytochrome P450 (CYP),158–159cannabis and,172D2/D3 agonist,14Dantrolenefor management of antipsychotic overdose,120NMS and,95Death. See also Toxicityfrom benzodiazepines in combination with opioids,29–30Brugada syndrome and,41from stimulants,171sudden,4Deep brain stimulation, TD and,189Delirium, antipsychotic medications and,13Delirium Rating Scale,16Dementia, polypharmacy, acute side effects of,129Depressiontreatment for,88–89in women,135DesipramineBrugada syndrome and,41Desmopressin, as cause of SIADH or hyponatremia,83Desvenlafaxinehepatotoxicity and,64, 65during pregnancy,136Deutetrabenazinefor management of antipsychotic medications,53TD and,187, 188Dexmethylphenidate, coronary vasospasm and,48Dextroamphetaminecoronary vasospasm and,48Dextromethorphan, serotonin syndrome and,159Diazepamcombined with opioids,31hepatotoxicity and,68for management of acute dystonia,6–7for management of serotonin syndrome,163risk of seizures with,151Dietary supplements, serotonin syndrome and,159Diltiazem, TD and,189Diphenhydraminefor management of acute dystonia,6for management of antipsychotic overdose,120for management of oculogyric crisis,105Disulfiram, ethanol and,169Diureticsas cause of SIADH or hyponatremia,83for management of myocarditis,46for management of noninflammatory cardiomyopathy,47Domperidone, NMS and,93Donepezil, hepatotoxicity and,68Dopamine D2 receptor–blocking agentsas cause of SIADH or hyponatremia,85for treatment of AV block,44Dose dumping,169Dosulepin, NMS and,93DSM-5-TRdescription of TD,184diagnosis of TD,185Duloxetineethanol and,168hepatotoxicity and,64nicotine and,173during pregnancy,137Dysarthria,4Dysautonomia,92Dystonia,1, 104. See also Acute dystonia; Oculogyric crisisdifferential diagnosis of,5incidence of,2location of,8management of,120risk factors for,8symptoms of,2Ecstasy. See 3,4-Methylenedi-oxymethamphetamineECT (electroconvulsive therapy), for NMS,95Edinburgh Postnatal Depression Scale,140Education, about risks of in utero medication exposure,141EEG (electroencephalogram),153Eicosapentaenoic acid, TD and,189Elderly. See also Hyponatremia; Polypharmacy, acute side effects ofcomorbidities in,129–130incidence of dystonia in,2risk of agranulocytosis in,6Electroconvulsive therapy (ECT), for NMS,95Electroencephalogram (EEG),153End-organ damage,79End-stage renal disease (ESRD), serotonin syndrome and,159, 160Ephedra, addiction to,170Ephedrine, hypertensive crisis and,77Epilepsy,85Epinephrinefor treatment of AV block,44for treatment of TdP,41EPS (extrapyramidal side effects),119Erectile dysfunction,107Ergotamine, serotonin syndrome and,159Escitalopramethanol and,168hepatotoxicity and,64ocular side effects of,101oculogyric crisis and,105during pregnancy,136TdP and,40Esmolol, for management of serotonin syndrome,163ESRD (end-stage renal disease), serotonin syndrome and,159, 160Ethanoladdiction to,177assessment of,169management of,169–170recognition and detection of,168–169Ethosuximide,agranulocytosis and,23Extrapyramidal side effects (EPS),119Eyes. See also Pigmentary cataract deposits; Pigmentary retinal deposits; Psychotropic medications, ocular side effects ofabnormal pigmentation of,100dilation of pupils,101double vision of,102–103farsighted vision,101Fentanylcombined with opioids,31serotonin syndrome and,159FGAs. See First-generation agents; First-generation antipsychoticsFirst-generation agents (FGAs)agitation and,12–13hepatotoxicity and,66polypharmacy, acute side effects of,128–129First-generation antipsychotics (FGAs),52TD and,181–182FluoxetineAV block and,4as cause of SIADH or hyponatremia,84discontinuation of,56–57ocular side effects of,101during pregnancy,136serotonin syndrome and,159Flupentixol, TD and,189Fluperlapine, TD and,189Fluphenazineacute dystonia and,3, 4agranulocytosis and,23hepatotoxicity and,66Flurazepam, combined with opioids,31Fluvoxaminehepatotoxicity and,64nicotine and,173ocular side effects of,101during pregnancy,136Folic acid, during pregnancy,142Food, hypertensive crisis and,77Gabapentin, hepatotoxicity and,68Galantaminehepatotoxicity and,68TD and,189G-CSF. See Granulocyte colony-stimulating factorGeneralized tonic-clonic seizures (GTCS),147, 148Ginkgo biloba, TD and,189Glaucomaacute angle-closure,100–102description of,100–101medication-associated,101recognition and detection of,101testing,102Granulocyte colony-stimulating factor (G-CSF)agranulocytosis and,23–24lithium and,23GTCS (generalized tonic-clonic seizures),147, 148“Guideline for Prescribing Opioids for Chronic Pain,”31Haloperidolacute dystonia and,3, 4agranulocytosis and,22–23nicotine and,174TdP and,40Heidelberg Retina Tomograph,100Hematopoietic growth factors, in management of agranulocytosis,25Hepatotoxicityantidepressants and,64–65antipsychotics and,66–67benzodiazepines and,68definition of,71mood stabilizers and,67–68nonbenzodiazepine receptor agonists and,68Hunter Serotonin Toxicity Criteria,158, 165, 171Huntington’s disease,183, 187Hydrocodone, combined with opioids,31Hydromorphone, combined with opioids,31Hyperammonemia, agitation and,14Hyperbolic tapering, anticonvulsants and,57Hypercalcemia, lithium and,14Hyperpyrexia,92NMS and,95Hypersensitivity syndrome,67Hypertensive crisis, associated with MAOIsassessment of,77–78culprit medications,77definition of,76, 79follow-up management of,78foods and,77illegal drugs and,77management of,78overview,75–76recognition and detection of,76–77Hypocalcemia,5Hyponatremia,12adverse outcomes of,82assessment of,86culprit medications and other causes,83–86antidepressants,83–84antiepileptic drugs,84–85antipsychotics,85psychogenic polydipsia,85–86definition of,81discontinuation syndrome and,86–87follow-up management of,87–88management of,86–87onset of,84overview,81–82recognition and detection of,82–83risk factors for,88Hypothyroidism, lithium and,14Iloperidone, TdP and,40Imipramineagranulocytosis and,23hepatotoxicity and,64nicotine and,173Indole, overdose of,121Infantsexposure to psychotropic medications,144PPHN and,136Infection, due to granulocytosis,25Intravenous Mg2+, TdP and,40Irritability. See also Agitationdescription of,11Isocarboxazid, hypertensive crisis and,75Ketamine, risk of seizures with,150Khat, addiction to,170Kidneys,81. See also Hyponatremiaserotonin syndrome and,161Lamotrigineagitation and,13–14Brugada syndrome and,41discontinuation of,54management during pregnancy,142myocarditis and,46ocular side effects of,103during pregnancy,138ventricular conduction delay and,45Laryngeal dystonia,7, 8Laryngospasm,4Lennox-Gastaut syndrome,148. See also SeizuresLeukocytosis, serotonin syndrome and,161Levetiracetamhepatotoxicity and,67TD and,189Levodopa, NMS and,93Levomilnacipran, during pregnancy,137LFTs (liver function tests),63, 71Lisdexamfetamine, coronary vasospasm and,48Lithiumagitation and,13–14AV block and,44Brugada syndrome and,41contraindication with NMS,96discontinuation of,53–54, 143assessment of,54follow-up management of,54management of,54recognition and detection of,53–54exposure to newborns,143granulocyte colony-stimulating factor and,23hepatotoxicity and,68hypercalcemia and,14hypothyroidism and,14management during pregnancy,142–143noninflammatory cardiomyopathy and,47ocular side effects of,103overdose of,111during pregnancy,137–138, 142, 144risk of seizures with,150sick sinus syndrome and,43toxicity,14, 15, 117, 122Liver,63–64. See also Hepatotoxicityassessment of,69cytochrome P450system,128ethanol and,168fatal damage to,68hepatic failure,70injury to,65, 67, 68Liver function tests (LFTs),63, 71Long-acting nitroglycerin, for management of coronary vasospasm,48Lorazepamcombined with opioids,31for management of acute dystonia,6–7for management of oculogyric crisis,105NMS and,95risk of seizures with,151Loxapineagranulocytosis and,23Brugada syndrome and,41LSD (lysergic acid diethylamide), addiction to,175Lurasidone, overdose of,121Lysergic acid diethylamide (LSD; acid), addiction to,175Magic mushrooms. See PsilocybinMajor depressive disorder, pramipexole for treatment of,14MAOIs. See Monoamine oxidase inhibitorsMDMA. See 3,4-Methylenedi-oxymethamphetamineMelatonin, TD and,189Memantine, hepatotoxicity and,68Mental status, altered,92Meperidine, serotonin syndrome and,159Mephenytoin, agranulocytosis and,23Mesoridazine, TdP and,40Methadonebenzodiazepines and,31combined with opioids,31hepatotoxicity and,68serotonin syndrome and,159TdP and,40Methamphetamine, coronary vasospasm and,48α-Methyldopa, TD and,1893,4-Methylenedioxymethamphetamine (MDMA)psychedelics and,175, 177serotonin syndrome and,159Methylphenidatecoronary vasospasm and,48ethanol and,169during pregnancy,139risk of seizures with,151stimulants and,171Metoclopramideacute dystonia and,4TD and,184Metoprolol, AV block and,44Mianserin, discontinuation of,55Mirtazapineagranulocytosis and,23as cause of SIADH or hyponatremia,83discontinuation of,55hepatotoxicity and,65overdose of,116during pregnancy,137serotonin syndrome and,159Mobitz type I (Wenckebach) AV block,43, 44treatment of,44Mobitz type II AV block,43, 44treatment of,44Monoamine oxidase inhibitors (MAOIs) agitation and,12agranulocytosis and,23associated with hypertensive crisis,75–79dosing,78ethanol and,168mechanism of action of,75NMS and,93nutrition and,78risk of seizures with,149–150, 152serotonin syndrome and,159stimulants and,170Mood stabilizersagitation and,13–14agranulocytosis and,23discontinuation of,53–55hepatotoxicity and,67–68risk of seizures with,150stimulants and,170–171Morphine, combined with opioids,31Morphine sulfate, for management of coronary vasospasm,48Movement disorders. See Tardive dyskinesiaMuscarinic receptors,126Muscle relaxants, for management of serotonin syndrome,164Mydriasis,101assessment of,104culprit medications,104description of,103–104follow-up management of,104management of,104recognition and detection of,104Myocarditisassessment of,46culprit medications,46description of,46endomyocardial biopsy for diagnosis of,46follow-up management of,46–47management of,46recognition and detection of,46Naloxone (Narcan),34Naltrexone, hepatotoxicity and,68Narcan (naloxone),34Narcotic analgesics, polypharmacy, acute side effects of,128Nebivolol, AV block and,44Nefazodone, hepatotoxicity and,64, 65Neuroleptic malignant syndrome (NMS)agitation and,13assessment of,15, 93–94culprit medications,92–93diagnosis of,93–94, 96EPS and,119follow-up management of,96incidence,91, 92as life-threatening emergency,96management of,94–95, 97mechanism of action of,91mortality of,92overview,91–92prognosis,96recognition and detection of,92restarting antipsychotic treatment after resolution of,97risk factors for,91–92Neutropenia. See also Agranulocytosis, with clozapine and other psychotropic medicationsdefinition of,21Nicotine and cigarette smokingaddiction to,177assessment of,174management of,174–175recognition and detection of,173–174electronic delivery of,174Nifedipine, TD and,189Nitroglycerine, for management of coronary vasospasm,48Nitroprusside, for management of serotonin syndrome,163NMS. See Neuroleptic malignant syndromeNonbenzodiazepine receptor agonistsagitation and,14hepatotoxicity and,68Nonbenzodiazepine sedative-hypnotics, ethanol and,169Noninflammatory cardiomyopathyassessment of,47culprit medications,47description of,47follow-up management of,47management of,47recognition and detection of,47Nonprescription drugsaddiction to,176stimulants and,171Nortriptylineagranulocytosis and,23Brugada syndrome and,41Nutrition, MAOIs and,78Nystagmus, ocular side effects of,103Oculogyric crisis,6–7. See also Dystoniaassessment of,105culprit medications,105description of,104–105follow-up management of,105management of,105recognition and detection of,105Olanzapineacute dystonia and,4hepatotoxicity and,66myocarditis and,46nicotine and,174oculogyric crisis and,105risk of seizures with,150Opioidsanxiety and,35in combination with benzodiazepinesassessment of,31–32culprit medications,31follow-up management of,35incidence,29–30management of,32–35overview,29–30recognition and detection of toxicity,30–31polypharmacy, acute side effects of,128serotonin syndrome and,159Opisthotonos,4Overt Agitation Severity Scale,16Oxazepam, risk of seizures with,151OxcarbazepineBrugada syndrome and,41as cause of SIADH or hyponatremia,83, 85, 88hepatotoxicity and,67during pregnancy,138Oxycodone, combined with opioids,31Oxygenfor management of acute dystonia,7for management of coronary vasospasm,48Oxymetazoline, hypertensive crisis and,77Paliperidoneacute dystonia and,4overdose of,121Parkinsonism,5ParoxetineAV block and,44as cause of SIADH or hyponatremia,84discontinuation of,56ocular side effects of,101during pregnancy,136Perphenazine, hepatotoxicity and,66Persistent postwithdrawal disorderanticonvulsants and,56antipsychotic medications and,52benzodiazepines and,58description of,51–52Z-drugs and,58Persistent pulmonary hypertension of the newborn (PPHN),136Pharyngeal spasms,4Phenelzinehepatotoxicity and,65hypertensive crisis and,75NMS and,93Phenothiazinesocular side effects of,100oculogyric crisis and,105pigmentary cataract deposits and,106pigmentary retinal deposits and,107TdP and,40Phentermine, hypertensive crisis and,77Phenylephrine, hypertensive crisis and,77Phenytoin, agranulocytosis and,23Phosphodiesterase inhibitorsvisual disturbances related to,107–108assessment of,108culprit medications,107description of,107follow-up management of,108management of,108recognition and detection of,107Physostigminefor management of antipsychotic overdose,120, 121for treatment of antimuscarinic toxicity,123Pigmentary cataract depositsassessment of,106culprit medications,106description of,105follow-up management of,106management of,106recognition and detection of,106Pigmentary retinal depositsassessment of,107culprit medications,107description of,106follow-up management of,107management of,107recognition and detection of,106Pimozide, acute dystonia and,3Pittsburgh Agitation Scale,16Polycyclic aromatichydrocarbons, nicotine and,173Polypharmacy, acute side effects ofadverse drug events,125assessment of,129culprit medications,126–129anticholinergics,126–127antipsychotics,128–129benzodiazepines,127–128opioids and narcotic analgesics,128definition of,125, 131follow-up management of,130management of,129–130, 131overview,125during pregnancy,144recognition and detection of,126PPHN (persistent pulmonary hypertension of the newborn),136Pramipexolefor treatment of bipolar depression,14for treatment of major depressive disorder,14Pregabalin, hepatotoxicity and,68Pregnancy, use of psychotropic medication duringassessment of,140culprit medications,136–140antipsychotics,139atomoxetine,139benzodiazepines,139–140bupropion,137carbamazepine,138lamotrigine,138lithium,137–138mirtazapine,137oxcarbazepine,138psychostimulants,139selective serotonin reuptake inhibitors,136serotonin-norepinephrine reuptake inhibitors,137topiramate,138trazodone,137tricyclic antidepressants,137valproic acid,138follow-up management of,142–143lamotrigine,142lithium,142–143SSRIs,142illnessdifficult cases,141–142mild,141moderate to severe,141lactation and,143management of,140miscarriage,136overview,135patient education and counseling,141psychiatric illness,143–144recognition and detection of,136Pregnancy and Lactation Labeling Rule,135Primidone, agranulocytosis and,23Prochlorperazineagranulocytosis and,23hepatotoxicity and,66TD and,184Promazine, agranulocytosis and,23PropranololAV block and,44for management of serotonin syndrome,163Pseudodystonia,5Pseudoephedrine, hypertensive crisis and,77Pseudomacroglossia,4Psilocybin (magic mushrooms), addiction to,175Psychedelics, addiction toassessment of,175management of,176recognition and detection of,175Psychoeducationabout agranulocytosis,26for seizures,154Psychogenic dystonia,5Psychogenic polydipsiaas cause of SIADH or hyponatremia,85–86, 89prevalence of,85treatment of,87Psychomotor agitation,11. See also Agitationagitation and,13description of,18rating scales of,16treatment for,17underlying cause of,18Psychostimulants, during pregnancy,139Psychotherapy, for treatment of hyponatremia,87Psychotropic medications. See also Agranulocytosis, with clozapine and other psychotropic medications; Pregnancy, use of psychotropic medication duringabrupt discontinuation of,144acute dystonia and,8addiction to,177follow-up management of,176discontinuation ofantidepressants,55–57antipsychotic medications,52–53benzodiazepines and Z-drugs,57–59collaborate effort with,60mood stabilizers,53–55overview,51–52withdrawal symptoms of,60hepatotoxicity andassessment of,68–69follow-up management of,70–71management of,70hepatotoxicity ofassessment of,68–69culprit medications,64–68antidepressants,64–65antipsychotics,66–67benzodiazepines,68mood stabilizers,67–68nonbenzodiazepine receptor agonists,68follow-up management of,70–75management of,70overview,63recognition and detection of,64infant exposure to,144life-threatening cardiac adverse events and,49ocular side effects of,99–109abnormal pigmentation of external ocular structures,99–100assessment of,100culprit medications,100follow-up management of,100management of,100recognition and detection of,99–100acute angle-closure glaucoma,100–102assessment of,101–102culprit medications,101description of,100–101follow-up management of,102management of,102recognition and detection of,101routine evaluation with eye specialist,102eye movement abnormalities not associated with oculogyric crisis,102–103assessment of,103culprit medications,103follow-up management of,103management of,103mechanism of,102recognition and detection of,102–103mydriasis and cycloplegiaassessment of,104culprit medications,104description of,103–104follow-up management of,104management of,104recognition and detection of,104oculogyric crisis,104–105assessment of,105culprit medications,105follow-up management of,105management of,105recognition and detection of,105overview,99pigmentary cataract deposits,105–106assessment of,106culprit medications,106follow-up management of,106management of,106recognition and detection of,106pigmentary retinal deposits,106–107assessment of,107culprit medications,107description of,106follow-up management of,107management of,107recognition and detection of,106visual disturbances related to phosphodiesterase inhibitors,107–108assessment of,108culprit medications,107description of,107follow-up management of,108management of,108recognition and detection of,107overdoses of,111–124antidepressants,116–117tricyclic,112–114antipsychotics,119–122atypical,120–122typical,119–120lithium,117–118overview,111psychiatric consultation of patients,118selective serotonin reuptake inhibitors,114–115serotonin-norepinephrine reuptake inhibitors,115–116supportive care and,122tricyclic antidepressants,112–114overview,xv–xvipersistent postwithdrawal disorder,51–52during pregnancy,140rebound symptoms,51toxicity from,122withdrawal symptoms,51Quetiapineacute dystonia and,4hepatotoxicity and,66–67risk of seizures with,150Quinolinones, toxicity from,121Rebound symptomsanticonvulsants and,56antipsychotic medications and,52benzodiazepines and,58description of,51Z-drugs and,58Repetitive transcranial magnetic stimulation (rTMS)risk of seizures with,152TD and,189Reserpine, TD and,189Restless legs syndrome (RLS), antipsychotic medications and,13Retina. See Pigmentary retinal depositsReversible inhibitors of MAO-A (RIMAs),76Richmond Agitation-Sedation Scale,16RIMAs (reversible inhibitors of MAO-A),76Risperidoneacute dystonia and,4overdose of,121oculogyric crisis and,105Ritonavir, serotonin syndrome and,159Rivastigmine, hepatotoxicity and,68RLS (restless legs syndrome), antipsychotic medications and,13rTMS. See Repetitive transcranial magnetic stimulationSchooler-Kane criteria,186Second-generation agents (SGAs)agitation and,12–13hepatotoxicity and,66polypharmacy, acute side effects of,129Second-generation antipsychotics (SGAs),52Seizuresassessment of,152culprit medicationsantidepressants,149–150antipsychotics,150–151anxiolytics,151mood stabilizers,150overview,149rTMS and psychoactive medications,152stimulants,151drop attacks,148EEG for,153epileptic,147epileptiform,147–148ethanol and,168follow-up management of,153–154grand mal,147GTCS,147management of,152–153overview,147–148prolonged,154rapid response team and,152–153recognition and detection,148–149generalized seizure types,148GTCS,148nonepileptiform seizures,148–149simple and complex partial seizure,148risks for,154status epilepticus,153toxicity-induced,120, 121Selective serotonin reuptake inhibitors (SSRIs)agitation and,11–12as cause of SIADH or hyponatremia,83discontinuation of,55–57ethanol and,168follow-up management of infant exposure to,142hepatotoxicity and,65NMS and,93ocular side effects of,101overdose ofassessment of,114follow-up management of,115management of,115recognition and detection of,114during pregnancy,136serotonin syndrome and,158, 159Selegilinehepatotoxicity and,64, 65hypertensive crisis and,75TD and,189Serotonin, toxicity,116Serotonin-norepinephrine reuptake inhibitors (SNRIs)agitation and,11–12agranulocytosis and,23as cause of SIADH or hyponatremia,83discontinuation of,55–57overdose ofassessment of,115follow-up management of,116management of,115–116recognition and detection of,115during pregnancy,137risk of seizures with,149–150serotonin syndrome and,159Serotonin syndrome,12, 119assessment of,159–162causes of,165characterization of,164culprit medications,158–159diagnosis of,171follow-up management of,164incidence of,157management of,162–164, 165overview,157–158patient-related causes of,157–158prognosis of,164psychedelics and,175recognition and detection of,158SSRIs and,158stimulants and,170symptoms of,158treatment as a medical emergency,172Sertralineagranulocytosis and,23ethanol and,168hepatotoxicity and,64during pregnancy,136serotonin syndrome and,159SGAs. See Second-generation agents; Second-generation antipsychoticsSIADH (syndrome of inappropriate antidiuretic hormone secretion),81Sick sinus syndrome (sinus node dysfunction)assessment of,43culprit medication,43description of,42follow-up management of,43management of,43recognition and detection of,42Sildenafil, visual disturbances related to,107–108SILENT (syndrome of irreversible lithium-effectuated neurotoxicity),117Sinus node dysfunction. See Sick sinus syndromeSleep-related activities, nonbenzodiazepines and,14SNRIs. See Serotonin-norepinephrine reuptake inhibitorsSodium,82–83. See also Hyponatremiabaseline,88Sodium channel blockers, ventricular conduction delay and,45SSRIs. See Selective serotonin reuptake inhibitorsStatus epilepticus,153Steatosis,63Steroids, risk of seizures with,152Stimulantsaddiction to,177assessment of,171management of,171–172recognition and detection of,170–171cannabis and,172–173death from,171ethanol and,169hypertensive crisis and,77risk of seizures with,151, 152St. John’s wort, serotonin syndrome and,159Substance use. See also Addictionserotonin syndrome and,160Succinylcholine, for management of serotonin syndrome,164Sudden death,4acute dystonia and,4Sulpiride, TD and,189Sympathomimetics,79hypertensive crisis and,77Syndrome malin des neuroleptiques. See Neuroleptic malignant syndromeSyndrome of inappropriate antidiuretic hormone secretion (SIADH),81Syndrome of irreversible lithium-effectuated neurotoxicity (SILENT),117Tacrine, hepatotoxicity and,68Tadalafil, visual disturbances related to,107–108Tardive akathisia,53agitation and,12–13Tardive dyskinesia (TD),53antipsychotic drugs and,190assessment of,185culprit medications,184–185description of,181differential diagnosis of,183DSM-5-TR description of,184DSM-5-TR diagnosis of,185pathophysiology of,181prevalence of,181–182recognition and detection of,184relapse of,189risk factors for,182–183treatment of,183–184, 190Tardive dystonia,5TCAs. See Tricyclic antidepressantsTD. See Tardive dyskinesiaTdP. See Torsades de pointesTemporal lobe epilepsies,5Δ-9-Tetrahydrocannabinol (Δ-9-THC),172Δ-9-THC (Δ-9-tetrahydrocannabinol),172Thiamine, TD and,189Thiazides, as cause of SIADH or hyponatremia,83Thiazine diuretics,12Thiopropazate, TD and,189Thioridazineagranulocytosis and,23hepatotoxicity and,66ocular side effects of,100pigmentary cataract deposits and,106pigmentary retinal deposits and,107polypharmacy, acute side effects of,129risk of seizures with,150TdP and,40Topiramateas cause of SIADH or hyponatremia,85hepatotoxicity and,66–67oculogyric crisis and,105during pregnancy,138Torsades de pointes (TdP)assessment of,40culprit medications,40description of,39management of,40–41recognition and detection of,40Torticollis,4Tortipelvic crisis,4Toxicity. See also Deathacute-on-chronic,117from antidepressants,174from antipsychotics,122idiosyncratic,63 -induced seizures, 120from lithium,14, 15, 117, 122nicotine and,174, 175opioid-benzodiazepines and,36from overdoses of psychotropic medications,111from psychotropic medications,122from quinolinones,121recognition and detection of,30–31with sertraline,65stimulants and,171–172Toxidromes,162, 164, 165. Seealso Serotonin syndromeTramadol, as cause of SIADH or hyponatremia,83Tranylcypromineagranulocytosis and,23hepatotoxicity and,65hypertensive crisis and,75Trazodonediscontinuation of,55hepatotoxicity and,64overdose of,116during pregnancy,137serotonin syndrome and,159Tricyclic antidepressants (TCAs)agitation and,12agranulocytosis and,23anticholinergic effects and,126–127AV block and,44Brugada syndrome and,41as cause of SIADH or hyponatremia,83ethanol and,168hepatotoxicity and,65myocarditis and,46NMS and,93ocular side effects of,101overdose ofassessment of,113follow-up management of,114management of,113–114recognition and detection of,112during pregnancy,137psychedelics and,175risk of seizures with,149, 152serotonin syndrome and,159stimulants and,170TdP and,40ventricular conduction delay and,45TrifluoperazineBrugada syndrome and,41hepatotoxicity and,66Trimethadione, agranulocytosis and,23Triptans, serotonin syndrome and,159Trismus,4L-Tryptophan, serotonin syndrome and,159Tyramine, dietary,76, 79ethanol and,168Urinedrug screening and,171retention of,162serotonin syndrome and,161Urological medications, anticholinergic effects and,127U.S. FDA Clozapine Risk Evaluation and Mitigation Strategy program,26, 27Valbenazinefor management of antipsychotic medications,53TD and,187, 188–189Valproateagitation and,13–14as cause of SIADH or hyponatremia,85discontinuation of,54hepatotoxicity and,67Valproic acidNMS and,93overdose of,111during pregnancy,138, 142Vardenafil, visual disturbances related to,107–108Vasodilators, for management of coronary vasospasm,48Vecuronium, for management of serotonin syndrome,164Venlafaxineethanol and,168hepatotoxicity and,64during pregnancy,137Ventricular conduction delayassessment of,45culprit medications,45description of,45follow-up management of,45management of,45recognition and detection of,45Vesicular monoamine transporter type 2 (VMAT2) inhibitors,53NMS and,93TD and,187, 191Vilazodonediscontinuation of,55risk of seizures with,150Vision. See also Eyes; Pigmentary retinal depositsblue tinge,107blurry,107, 127double,102–103nighttime,106visual disturbances related to phosphodiesterase inhibitors,107–108Vitamin B6, TD and,189Vitamin E, TD and,189VMAT2. See Vesicular monoamine transporter type 2 inhibitorsVortioxetine, discontinuation of,55Wilson’s disease,5Withdrawal symptomsantipsychotic medications and,52description of,51Women. See also Pregnancy, use of psychotropic medication duringdepression and anxiety in,135with mental illness during pregnancy,144reproductive safety data for,144SIADH and,81with TD,182–183Young Mania Rating Scale,16Zaleplon, combined with opioids,31Z-drugscombined with opioids,31discontinuation of,57–59assessment of,58follow-up management of,59management of,58–59recognition and detection of,57–58persistent postwithdrawal disorder,58rebound symptoms,58withdrawal symptoms,57–58Ziprasidoneacute dystonia and,4overdose of,121risk of seizures with,150TdP and,40Zolpidem, combined with opioids,31Zopiclone, combined with opioids,31