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POLYPHARMACY INDUCED DELIRIUM: A CASE REPORT HIGHLIGHTING THE IMPORTANCE OF A THOROUGH PSYCHIATRIC HISTORY AND PHYSICAL EXAMINATION

Mohammed Ali, Rizwan Amin, Naziya Hassan, Robert P. Duprey Jr, Mariam Baig

A combative, aggressive 65-year-old female was brought to the emergency room (ER) after found wandering in the streets. Agitated, confused, disoriented in a delirious state, she was admitted to Psychiatric ER for diagnostic clarification. All labs except low platelets were within normal limits (WNL). Imaging did not show any changes. She was not a known neuro-cognitive disorder patient. Poly-pharmacy was ruled in as the etiology of the delirium, highlighting the importance of careful prescribing, especially in older persons. Moreover, this case highlights the importance of having expert knowledge in (a) the prescribing of psychotropic medication to include mechanism of action, side effects, and interactions, (b) treating delirium, and (c) the importance of a thorough history and physical examination. From this case report, the authors recommend consulting psychiatry as a standard of care in treating delirium.

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