kendra’s law

Kendra’s law is named after a 32 years old journalist, who was pushed in front of the train by a man with mental illness history. This law strived to create a “assisted outpatient treatment” option which will allow mental illness patient to receive appropriate treatment instead of just pushing them in the criminal justice system or in the community. Before this law, individual with mental illness were always placed in in the criminal justice system and if he/she ever reached the hospital then they would only be stabilized and then released to the community without supervision. In 1999 Kendra’s Law was established and it is a court order that established a treatment plan for individuals with severe mental illness

 

 

What is tardive dyskinesia?

If an individual is treated with dopaminergic antagonist medications for long term then he/she can develop involuntary movements of the tongue, lips, face, trunk, and extremities which is known as tardive dyskinesias (TDs). Tardive dyskinesias most often affects the orofacial and tongue muscles and less commonly affects the trunk and extremities. Tardive dyskinesias is common among patients with schizophrenia, schizoaffective disorder, or bipolar disorder because these patients are usually treated with antipsychotic medication for long periods of time. Also, elderly female is more susceptible to TDs. If TDs is suspected or diagnosed on a patient, then the causative agent should be withdrawal, or the dose should be reduced.

 

Serotonin syndrome-

Serotonin syndrome is life threatening situation which can develop if high concentration of serotonin accumulates in the body. Naturally, serotonin is produced by our body to maintain the brain and nerve function but too much serotonin in the system can cause mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity. Most often Serotonin syndrome is participated by use of “serotonergic drugs and overactivation of both the peripheral and central postsynaptic 5HT-2A receptors”. Therefore, while taking patient history, providers should pay attention these types of drugs: Selective serotonin reuptake inhibitors (SSRIs), antidepressants such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine, paroxetine (Paxil, Pexeva, Brisdelle) and sertraline (Zoloft). The diagnosis of Serotonin syndrome is mostly clinical so a through history of prescription drug use, over-the-counter medication and dietary supplement use, and illicit substance is essential to identify the syndrome early. However, the gold standard for diagnosis is a medical toxicology. Additionally, pay close attention to end stage renal disease patient because these patients are more prone to developing the syndrome.

 

Steven Johnson syndrome

Stevens-Johnson syndrome (SJS) is a rare disorder and it is usually caused by a medication reaction. Patient with SJS most likely will present with flu like symptoms followed by a painful rash and blisters. SJS is a most commonly adverse reaction of the following medications: allopurinol, carbamazepine, lamotrigine, nevirapine, phenobarbital, phenytoin, sulfamethocazole and other sulfa antibiotics, sertraline and sulfasalazine. The diagnosis of SJS is based on symptoms, PE and medical history . Overall, Stevens-Johnson syndrome is a medical emergency, which need to be treated in the in hospital, often in intensive care or a burns unit.

 

 

Sources:

1. https://mentalillnesspolicy.org/kendras-law/kendras-law-overview.html
2. https://www.wamc.org/post/story-behind-kendra-s-law
3. https://emedicine.medscape.com/article/1151826-overview
4. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
5. Volpi-Abadie, J., Kaye, A. M., & Kaye, A. D. (2013). Serotonin syndrome. The Ochsner journal, 13(4), 533–540.
6. https://www.nhs.uk/conditions/stevens-johnson-syndrome/