Don’t routinely use antidepressants as first-line treatment for mild or subsyndromal depressive symptoms in adults.

There is no evidence to support ordering routine toxicology testing for all patients presenting to the psychiatry  emergency room service. Furthermore, routine testing presents the potential for false positives and false negatives. Lastly, testing may delay psychiatric assessment and management.

 

Sources:

Akosile W, et al. Use of the urine drug screen in psychiatry emergency service. Australas Psychiatry. 2015;23:128-131. PMID: 25676213.

Korn CS, et al. “Medical clearance” of psychiatric patients without medical complaints in the emergency department. J Emerg Med. 2000 Feb;18(2):173-176. PMID: 10699517.

Kroll DS, et al. Drug screens for psychiatric patients in the emergency department: evaluation and recommendations. Psychosomatics. 2013;54(1):60-66. PMID: 23194932.

Olshaker JS, et al. Medical clearance and screening of psychiatric patients in the emergency department. Acad Emerg Med. 1997 Feb;4(2):124-128. PMID: 9043539.

Schiller MJ, et al. Utility of routine drug screening in a psychiatric emergency setting. Psychiatr Serv. 2000 Apr;51(4):474-78. PMID: 10737822.

Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol. 2009 Apr;47(4):286-91. PMID: 19514875.