Lying about a med to a psych patient - page 4

I'm interning in the emergency department right now. We recently had a schizophrenic patient come in and then had a major breakdown, becoming very violent and throwing tables at staff members. He... Read More

  1. Visit  Malanya profile page
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    Quote from Esme12
    Many chronic psych patients KNOW their drugs and will refuse psych meds because they don't like the way they make them "feel". In the interest of everyone, even though you aren't "supposed to", a little white lie doesn't hurt when someone is psychotic in an Emergency Room. MunoRN is essentially right but I have always considered it part of implied consent.
    As long as the way the chronic psych patient is wanting to avoid "feeling" is the extreme pain of EPSE, your first reaction would be legit IMHO. While I've never been combative in an ER, a situation did arise where I was given Haldol, and developed severe EPSE. I have never been in that much muscular pain in my life, and it wasn't confined to just one muscle group.

    Really, given that less potent neuroleptics are less likely to cause EPSE and NMS, I don't understand why haloperidol and droperidol are still so commonly used. It might be a bigger shot to use Thorazine, but if your combative is screaming "No Haldol", there might be a reason that's more than just that they don't like how it "feels"....and if you aren't sure why they're rejecting one particular one, go for one that has a slightly less intense side effect profile JIC.
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