Sedation and antipsychotics Rachel Shynn Clinical Nurse Educator Community Mental Health Definition se·da·tion 1.the calming of mental excitement or abatement of physiological function, esp. by the administration of a drug. 2. the state so induced. http://dictionary.reference.com/ Sedation Sedation is associated with both newer and traditional antipsychotics. Tends to be more pronounced at the initiation of therapy or upward dose titration. Starting at low doses and stepping up the dose slowly can reduce the impact. Patients should be warned to expect sedation in the early stages of treatment Therapeutic guidelines psychotropic, version 5. 2003. Sedation Sedation is divided in 3 areas: Sedation for the acutely disturbed client. Sedation as a adverse effect. Sedatives as individual agents Acutely disturbed client In most cases the urgent need with acutely disturbed patient is to achieve sedation to: Reduce the risk of the pt harming themselves or others. Reduce agitation, acute psychotic symptoms. Allow diagnostic assessment to proceed Allow transport to an appropriate treatment setting Sedation as a adverse effect All antipsychotic drugs, if given in sufficiently high doses, have sedative effects. Antipsychotics can cause sedation within, and even in some cases below, the optimal therapeutic range. These effects are often temporary, Need to assure the pt that the degree of sedation is likely to decline over 1-2 weeks. Therapeutic guidelines psychotropic, version 5. 2003. Continue If the degree of sedation is unacceptable- pt safety and well being, then reduce dose and or changing to a less sedating drug. Most sedating The most sedating of the commonly used drugs are Clozapine chlorpromazine Olanzepine Quetiapine and Zuclopenthixol. Sedatives as individual agents. Anxiolytics and Hypnotics Benzodiazepines- eg Clonazepam, diazepam, lorazeapm, nitrazepam, temazepam, alprazolam. These are mainly effective in relieving anxiety symptoms and will induce sleep if given in larger doses. Drowsiness is a common initial reaction psychomotor performance may be impaired also given for drug withdrawal. Mims online Nursing implications After sedation has been achieved (acutely disturbed and -ve adverse effects) pt may need to be: monitored closely (+ Calm and supportive) Vital signs monitored for other adverse effects-respiratory depression, excessive sedation, dystonic reaction such as choking). Legal implications- Poisons act etc Management of mental disorders, Volume 2. WHO: Fourth edition.