Common Toxic Syndromes in Psychiatric Practice

Abstract

Poisonings and toxic substance exposures are prominent causes of morbidity and mortality in psychiatry. Entoxications which are confronted frequently include clinical scenarios ranging from known drug overdose or drug interactions, as well as, illicit drug use, suicide attempt, or accidental exposure. The clinical evaluation and management of such patients remain challenging. Recognition of major toxic syndromes is important for accurate diagnosis and treatment as well as rapid stabilization of patients and resuscitation. The main focus of this article is to discuss common toxic syndromes (symptom patterns of specific poisoning). These common toxic syndromes include serotonin syndrome, neuroleptic malignant syndrome, anticholinergic, sympathomimetic, opiate, sedative/hypnotic, cholinergic toxic syndromes. All of these syndromes are closely associated with psychiatric signs and symptoms. If recognized early and appropriate treatment is initiated rapidly, majority of patients display favourable outcome.

Keywords

• Serotonin Syndrome, Neuroleptic Malignant Syndrome, Toxic Syndromes, Poisoning, Treatment

Psikiyatride Sık Karşılaşılan Toksik Sendromlar

Öz

Psikiyatride zehirlenmeler ve toksik maddelere maruz kalma, mortalite ve morbiditenin önemli bir sebebidir. Sık karşılaşılan bu durumlar, bilinen ilaçların aşırı dozları veya ilaç etkileşimlerinin yanı sıra, yasa dışı madde kullanımı, intihar girişimi veya kazara maruziyete kadar değişen klinik senaryoları kapsamaktadır. Bu hastaların klinik değerlendirilmesi ve tedavisi önemli zorluklar taşımaktadır. Hızlı stabilizasyon ve resusitasyonun yanı sıra major toksik sendromların tanınması, doğru tanı ve tedavi için önemlidir. Bu yazıda özgül zehirlenme örüntülerini oluşturan sık karşılaşılan klinik tablolar (toksik sendromlar) tanımlanmıştır. Sık karşılaşılan toksik sendromlar arasında serotonin sendromu, nöroleptik malign sendrom, antikolinerjik, sempatomimetik, opioid, sedatif hipnotik ve kolinerjik toksik sendromlar yer almaktadır. Bu sendromların tümüne psikiyatrik bulgu ve belirtiler eşlik etmektedir. Erken tanı ve uygun tedavi hızla başlanırsa, hastaların büyük çoğunluğunda olumlu sonuçlar alınabilmektedir.

Anahtar Kelimeler

• Serotonin Sendromu, Nöroleptik Malign Sendrom, Toksik Sendromlar, Zehirlenmeler, Tedavi

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