ABSTRACT
In addition to the psychiatrist’s usual concerns about poly(psycho)pharmacy, treating the medically ill psychiatric patient introduces many additional considerations related to the effects of organ dysfunction and the side effects of nonpsychiatric medications. Both medical illnesses and nonpsychiatric medications have the potential to affect neuro-psychiatric symptoms as well as to interact adversely with many psychotropic medications. Likewise, psychotropic medications themselves have many neuropsychiatric and somatic side effects. The newer antidepressants and atypical antipsychotics offer many advantages over the older generation of psychiatric drugs, but even they require caution in order to minimize iatrogenic morbidity in the medically ill patient.
