Articles in Psychiatry (3)

Delirium tremens is a life-threatening medical emergency representing the most severe manifestation of acute alcohol withdrawal, characterized by profound central nervous system hyperexcitability, global confusion, and autonomic instability. The gold-standard diagnostic assessment combines the clinical CIWA-Ar scoring protocol with targeted serum electrolyte and metabolic panels, while first-line management relies on aggressive symptom-triggered or front-loaded benzodiazepine therapy accompanied by parenteral thiamine replacement.

Serotonin syndrome is a potentially life-threatening drug-induced condition caused by excessive central and peripheral nervous system serotonergic agonism, characterized by neuromuscular hyperactivity, autonomic instability, and altered mental status. Diagnosis is established via the Hunter Serotonin Toxicity Criteria, and management centers on immediate cessation of serotonergic agents, supportive care with benzodiazepines, and administration of cyproheptadine in moderate-to-severe presentations.

Neuroleptic malignant syndrome is a rare, life-threatening idiosyncratic reaction to dopamine receptor antagonists or abrupt dopaminergic withdrawal, characterized by hyperthermia, extreme muscle rigidity, autonomic instability, and altered mental status. Diagnosis is clinical supported by markedly elevated serum creatine kinase and leukocytosis, while first-line management requires immediate offending drug cessation, intensive care unit supportive cooling, aggressive intravenous hydration, and targeted pharmacotherapy with dantrolene or bromocriptine.