C-L Psychiatrists have to be keenly aware of adverse effects and toxicity from psychiatric medications in therapeutic use and in overdose. Assessments are complicated by altered mentation in reporting patients along with their chronic medical and psychiatric illnesses and interacting drug regimens. The transplant psychiatrist’s work is further nuanced as their patients present with altered physiologies requiring exquisitely fine-tuned pharmacology. Serving as a consultant or embedded collaborator requires a robust knowledge of the impact of psychiatric medications on various organ systems. This symposium will expand on principles from transplant psychiatry and medical toxicology to highlight the effects of medications on organ systems apart from the central nervous system.
Understanding liver physiology and function is key in a multitude of scenarios such as relevant cytochrome p450 interactions, overdose, acute and chronic alcohol problems, and hepatic encephalopathy to name a few. Similarly, appreciation for the pathophysiology of acute and chronic kidney damage will help the clinician better manage both acute ingestions and chronic issues like bipolar disorder complicated by a downward functional trajectory towards hemodialysis. Cardiovascular function is a focus in patients with arrhythmias, stroke, and hypertension as well as those who take antidepressant and antipsychotic medications. Several additions to the patients’ armamentarium against anxiety such as cannabis in its different delivery forms are harmful to the lung parenchyma. Prescribed psychotropics have fairly rare, but potentially serious toxicities in other tissues like the eye, the pancreas, skin, and integument.
Dr. Winder will discuss common effects of psychiatric and substance use disorder (SUD) medications on the liver as well as how the liver is affected in other psychiatric and SUD emergencies. Dr. Hussain will provide a synopsis of medication effects on the cardiopulmonary system. Dr. Shenoy will discuss drug induced renal injury and ways to effectively manage psychotropics in the face of kidney damage. Dr. Rasimas will address the impact of medications on the pancreas and the less-often thought about dermatologic, ophthalmologic and orthopedic effects of medications. Together with the specific expertise highlighted by other speakers, he will synthesize core concepts for C-L psychiatrists to excel at collaboration on complex medical cases involving potential for organ toxicity balanced against proposed benefits of medications. Time will be protected for audience discussion and questions.