A consultation-liaison psychiatry team is reviewing common adverse effects of various psychotropic medications to update hospital safety protocols. Match each clinical presentation of an adverse drug reaction with the medication most likely responsible.
- Polyuria, polydipsia, new-onset fine tremor, and elevated thyroid-stimulating hormone (TSH).Lithium
- Excessive sialorrhea, generalized tonic-clonic seizures, and severe neutropenia.Clozapine
- Rapidly spreading maculopapular exanthem with oral mucosal blistering and epidermal detachment.Lamotrigine
- Acute altered mental status, asterixis, and hyperammonemia in the setting of elevated transaminases.Valproate
Answer
The presentations match as follows: polyuria/tremor/hypothyroidism with Lithium; sialorrhea/seizures/neutropenia with Clozapine; mucosal blistering rash with Lamotrigine; and hyperammonemic encephalopathy with Valproate.
Each psychotropic medication has a distinct adverse effect profile that is critical for clinical monitoring. Lithium causes nephrogenic diabetes insipidus and hypothyroidism. Clozapine causes agranulocytosis and lowers the seizure threshold. Lamotrigine can cause Stevens-Johnson syndrome. Valproate can cause hyperammonemic encephalopathy and hepatotoxicity.
Step-by-Step Solution
Key Concept
Adverse effect profiles of psychotropic medications