Families may ask for help with behaviour changes that cannot be
explained, including strange or frightening behaviour (withdrawal,
Refer to card on Delirium - F05 for other potential causes. If
psychotic symptoms are recurrent or chronic, also see Chronic psychotic
disorders - F20. If symptoms of mania (elevated mode, racing speech or
thoughts, exaggerated self-worth) are prominent, the patient may be
experiencing a manic episode. See Bipolar disorder F31. If low or sad
mood is prominent, also see Depression F23.
Acute psychotic disorder - management guidelines
Essential information for patient and family
Advise family about legal issues related to mental health treatment.
Counselling of patient and family
Ensure the safety of the patient and those caring for him/her:
Agitation which is dangerous to the patient, the family or the community requires hospitalization or close observation is a secure place. If patients refuse treatment, legal measures may be needed
Encourage resumption of normal activities after symptoms improve.
Antipsychotic medication will reduce psychotic symptoms (e.g. haloperidol 2-5 mg up to three timed a day or chlorpromazine 100-200mg up to three times a day). The dose should be the lowest possible for the relief of symptoms, though patients may require higher doses.
Anti-anxiety medication may also be used in conjunction with neuroleptics to control acute agitation (e.g., lorazepam 1-2mg up to four times a day).
Continue antipsychotic medication for at least three months after symptoms resolve.
Monitor for side effects of medication:
If possible, consider consultation for all new cases of psychotic disorder. In cases of severe motor side-effects of the appearance of fever, rigidity, hypertension, stop antipsychotic medication and consider consultation.