Polypharmacy Induced Delirium: A Case Report Highlighting the Importance of a Thorough Psychiatric History and Physical

A combative aggressive 65 year old female was brought in to the Emergency Room (ED)
after found wondering in the streets. Agitated, confused, disoriented in a delirious state,
she was admitted to psychiatry for diagnostic clarification. All labs except low platelets were
Within Normal Limits (WNL). Imaging was normal. 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, effects, side effects, and interactions, (b) treating delirium,
and (c) the importance of a thorough history and physical. From this case report, the authors
recommend consulting psychiatry as a standard of care in treating delirium.