Put your knowledge and skills to the test with the case of a 19 year old man who presents with anxiety, agitation, isolation, social withdrawal, and paranoia. He is determined by the healthcare team to be experiencing his first psychotic break, is given the diagnosis of psychosis - not otherwise specified, and is treated first with risperidone and then haloperidol.
A year later, the patient presents again to hospital with the same symptoms (as above), as well as a recent history of alcohol abuse. Several medications are tried, but his symptoms persist and he remains unable to resume his normal activities. Eventually, he is prescribed clozapine, an atypical antipsychotic approved for use in treatment-resistant schizophrenia. This new medication helps to relieve his psychotic symptoms, but his heart rate is persistently elevated.
Can you determine the cause of this patient's tachycardia or come up with a management plan?
"A young man with psychosis whose heart is racing" by Kim Brownell, Dana Sinopoli, Karlyn Huddy, and Amy Taylor (Current Psychiatry)
A year later, the patient presents again to hospital with the same symptoms (as above), as well as a recent history of alcohol abuse. Several medications are tried, but his symptoms persist and he remains unable to resume his normal activities. Eventually, he is prescribed clozapine, an atypical antipsychotic approved for use in treatment-resistant schizophrenia. This new medication helps to relieve his psychotic symptoms, but his heart rate is persistently elevated.
Can you determine the cause of this patient's tachycardia or come up with a management plan?
"A young man with psychosis whose heart is racing" by Kim Brownell, Dana Sinopoli, Karlyn Huddy, and Amy Taylor (Current Psychiatry)
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