Conditions We Treat

The Center for Interventional Psychiatry at Western Psychiatric Institute and Clinic of UPMC specializes in conditions that do not respond to usual treatments.

For some conditions, few treatments exist, and for others, standard treatments have not improved the patient's symptoms.

Some patients are unable to take the medications they need because of side-effects, or may also refuse to take the medication that is prescribed.

In many cases, a treatment such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may offer the quickest relief from severe symptoms of certain psychiatric disorders.

The Center for Interventional Psychiatry cares for patients who have already received a diagnosis, and for those who are being diagnosed for the first time. We specialize in treating these conditions:

Hard-to-treat depression

The symptoms of depression in most people may include:

• Sadness that does not go away
• Lack of energy
• Not being able to sleep or sleeping too much
• Loss of appetite
• Not being able to find pleasure in activities that are usually enjoyable

Severe or persistent depression is typically treated with antidepressant medication and counseling with a psychiatrist or other mental health professional. If a major depressive disorder does not improve, becomes worse, or does not respond with these treatments, you may be experiencing hard-to-treat depression.

Catatonia

Catatonia is a syndrome or state that can result from either psychiatric or medical disorders. A person in this state may be:

• Mute
• Not interacting with other
• Not eating
• Immobile

This condition is especially dangerous because the person affected can be dehydrated, malnourished, or develop pressure sores from staying in the same position.

Mania, or being in an extremely excitable or agitated state, is usually found in bipolar disorder.

Mania is often treated with medicines. However, some patients may not be able to take the medicines or do not respond to medicine. This makes their mania hard-to-treat.

Hard-to-treat schizophrenia

Schizophrenia is a chronic condition that has no cure and will usually need lifelong treatment. The condition itself is not treated, but instead, the symptoms are treated.

Some symptoms include:

• Psychosis
• Auditory or Visual Hallucinations
• Sometimes catatonia

Typical treatment for schizophrenia is a combination of medication and specialized programs that may help with interacting socially and coping with daily life. Patients who do not respond well to these treatments, or whose symptoms are severe, may have difficult-to-treat schizophrenia.

Neuroleptic malignant syndrome

This is a rare condition that can occur as a reaction to treatment of certain medications which are often used to treat psychiatric disorders or can happen in response to discontinuing other medications abruptly.

Neuroleptic malignant syndrome can be very serious, even life-threatening, and should be treated as a medical emergency.

The symptoms are mainly caused by the autonomic nerve system, and can include:

• High fever
• Sweating
• Changes in blood pressure
• Extreme confusion, almost unconscious (stupor)
• Muscle stiffness