Psychopharmacology in the intensive care unit

The ICU is a psychiatrically hazardous place for the severely ill patient. In addition to a multitude of neuromedical causes for psychiatric dysfuncti on, there are significant psychological challenges that ICU patients must f ace. Agitation secondary to delirium, psychosis, or pain can imperil the op timal management required for the patient's recovery. Anxiety, depression, and sleep dysfunction may make the patient's recovery harder to achieve. In the pediatric patient as in the adult, organic disease should be considere d as a possible underlying cause of psychosocial dysfunction. The trauma of the ICU experience will manifest in ways that can be related to a child's stage of development. Psychopharmacologic treatments that are tailored to the geriatric, adult, a nd pediatric populations can be essential components of patient management in the ICU; these treatments can often prevent harm and alleviate distress in critically ill patients.