What to do when PO isn’t an option. A Case Review and Literature Review of Parental Options for Psychotropic Medications
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
An unknown patient comes into the ER with multiple GSW to the abdomen which then lead to injuries in their gastrointestinal tract. Psychiatry was consulted due to increasing agitation in the patient s/p multiple exploratory laparotomies. Due to the patient’s extensive damage to their GI tract and inability to absorb medication by mouth, the CL team began to explore various parenteral routes of administration for psychotropic medications to address the consult. Parenteral administration of psychotropic drugs is essential in the management of acute psychiatric conditions, particularly when oral administration is not feasible. This literature review examines various parenteral formulations, including intramuscular, intravenous, and subcutaneous routes, highlighting their pharmacokinetics, efficacy, safety, and clinical applications. A comprehensive analysis of 18 existing studies was conducted to compare the advantages and limitations of different administration routes. Various common options from treatment included uses of IV/IM Antipsychotics (Zyprexa, Haldol, Geodon, Etc.), IV anticonvulsants (Depacon), IV Benzodiazepines, IV Alpha 2 agonist (Precedex). Less common options include the use of Intranasal and IV ketamine, transdermal patches, inhaled antipsychotics, rectal administration of benzodiazepines, and liquid formulations of antidepressants. Overall based on these reviewed case reports and literature there are numerous options for addressing psychiatric symptoms without a functional GI tract.
Recommended Citation
Williams, Brock MD, "What to do when PO isn’t an option. A Case Review and Literature Review of Parental Options for Psychotropic Medications" (2025). Dept. of Psychiatry Research Symposium. 29.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/29
What to do when PO isn’t an option. A Case Review and Literature Review of Parental Options for Psychotropic Medications
Center for Advanced Learning and Simulation (CALS)
An unknown patient comes into the ER with multiple GSW to the abdomen which then lead to injuries in their gastrointestinal tract. Psychiatry was consulted due to increasing agitation in the patient s/p multiple exploratory laparotomies. Due to the patient’s extensive damage to their GI tract and inability to absorb medication by mouth, the CL team began to explore various parenteral routes of administration for psychotropic medications to address the consult. Parenteral administration of psychotropic drugs is essential in the management of acute psychiatric conditions, particularly when oral administration is not feasible. This literature review examines various parenteral formulations, including intramuscular, intravenous, and subcutaneous routes, highlighting their pharmacokinetics, efficacy, safety, and clinical applications. A comprehensive analysis of 18 existing studies was conducted to compare the advantages and limitations of different administration routes. Various common options from treatment included uses of IV/IM Antipsychotics (Zyprexa, Haldol, Geodon, Etc.), IV anticonvulsants (Depacon), IV Benzodiazepines, IV Alpha 2 agonist (Precedex). Less common options include the use of Intranasal and IV ketamine, transdermal patches, inhaled antipsychotics, rectal administration of benzodiazepines, and liquid formulations of antidepressants. Overall based on these reviewed case reports and literature there are numerous options for addressing psychiatric symptoms without a functional GI tract.