Medication is frequently an adjunct to crisis therapies and initially may be the primary treatment method. The choice of a regimen depends on the identification of a drug-responsive syndrome (see Chart I) and on the evaluation of possible risks from medical conditions, side effects, potential abuse, and other medications. If suicidal symptoms interfere with adequate cooperation in psychotherapy the clinician should administer medication early in treatment. Intense confusion, feelings of helplessness and despair, and preoccupation with internal cues may predominate the patient’s awareness, particularly in individuals with major affective disorders or schizophrenialike psychoses. These characteristics may significantly limit the usefulness of ego supportive approaches, that encourage cooperation and rapport with the clinician, reestablishment of previously effective social attachments, and the mobilization of cognitive defenses. Frequently, patients with affective and psychotic disorders improve only after therapeutic doses of medication are administered for several weeks. The sedative, antianxiety, and neuroleptic properties of antipsychotic agents and the cyclic antidepressants, however, provide more immediate relief.
KeywordsAntipsychotic Agent Suicidal Patient Major Affective Disorder Severe Central Nervous System Cyclic Antidepressant
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