Source / episode info

• **Episode:**23
• **Title:**Divine Intervention Episode 23 – Comprehensive 3rd Year Psychiatry Shelf Review.
• **Published:**2018-04-25
• Source:Episode page

One-liner

This review emphasizes the differential diagnosis of psychosis based on symptom duration and clusters, details the pharmacology and specific adverse effect profiles of various antipsychotics, and differentiates key personality disorders.

High-yield summary

• Schizophrenia Diagnosis: Requires symptoms (delusions, hallucinations, disorganized speech/behavior, negative symptoms) for a minimum of 6 months, with at least two of five core symptoms present.
• Antipsychotic Choice: Atypical neuroleptics are generally preferred over typical ones (e.g., Haloperidol) due to reduced risk of EPS.
• Drug Safety Pearls:
• Clozapine: The only antipsychotic proven to decrease the risk of suicide in schizophrenia; associated with agranulocytosis.
• Risperidone: Highest association with hyperprolactinemia (due to tuberoinfundibular pathway blockade).
• Olanzapine: Strongest association with metabolic syndrome (weight gain, elevated HbA1c, dyslipidemia).
• Ziprasidone: Strongest association with QT interval prolongation.
• Timeframe Differentiation: Schizophreniform Disorder (< 6 months); Brief Psychotic Disorder (< 1 month).

Learning objectives

• Differentiate the diagnostic criteria for various psychotic disorders based on symptom duration and clusters.
• Select appropriate antipsychotic agents while considering specific adverse effect profiles (e.g., hyperprolactinemia, metabolic syndrome).
• Recognize and manage acute extrapyramidal symptoms (EPS) such as dystonia, akathisia, and tardive dyskinesia.