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mental health

Psychiatric Medications and Monitoring

Psychiatric medications require careful monitoring for effectiveness and serious adverse effects. Nurses support adherence and patient safety.

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Key Points to Know

What you must know about Psychiatric Medications

1

Typical antipsychotics (e.g., haloperidol) commonly cause extrapyramidal side effects (EPS).

2

Watch for acute dystonia, akathisia, parkinsonism, and tardive dyskinesia with antipsychotics.

3

Lithium requires regular blood level monitoring due to its narrow therapeutic range.

4

Advise adequate fluid and salt intake with lithium to prevent toxicity.

5

SSRIs may cause serotonin syndrome, especially when combined with other serotonergic drugs.

6

Emphasise adherence — stopping medication abruptly can trigger relapse.

NMCN Exam Tips

How this topic appears in the NMCN exam

EPS is the hallmark antipsychotic side effect to monitor.

Lithium levels must be monitored (narrow therapeutic index).

Antidepressants take weeks to work — continue and monitor.

Never stop psychiatric drugs abruptly (relapse/withdrawal risk).

Practice Question

Test yourself

A patient on haloperidol develops muscle rigidity, tremors, and a shuffling gait. The nurse recognises these as:

A.Signs of improvement
B.Extrapyramidal side effects✓ Correct
C.Symptoms of the underlying illness
D.An allergic reaction to the drug

Explanation

Muscle rigidity, tremors, and a shuffling gait are extrapyramidal side effects (drug-induced parkinsonism) commonly caused by typical antipsychotics such as haloperidol. The nurse should report these and anticipate management (e.g., anticholinergic medication).

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