PSYCH WARD
INTRODUCTION
Card game for 2 or more players.
Players are medical professionals working in a hospital psych ward.
Match drugs to diagnoses to score points.
OBJECTIVE
The game ends when all patients have been successfully treated.
The player, at the end of the game, with the most patients in his file is the winner.
THE DECKS
Players share two common decks:
The Patient Deck, and the Treatment Deck.
The decks contain one of each card described in the lists.
THE PATIENT DECK
Each card represents a patient.
The card describes the patient’s diagnosis and treatment requirements.
THE TREATMENT DECK
The treatment deck has two types of cards:
Drug Cards (used to treat) and
Contraindication Cards (used to negate treatments)
Note: A few Drug cards describe non-pharmacological treatment options.
Contraindication cards represent ADR’s (Adverse Drug Reactions), Side effects,
Co-morbid disease states, Drug interactions, Kinetics, Dynamics, Dosing, and
Administration errors that would result in therapeutic failure.
SETUP
Each player starts with a hand of 5 random treatment cards.
Determine Turn order (the player with the longest name goes first).
TURN SEQUENCE
Players take turns.
Each turn has 3 Phases:
Admissions Phase
Pharmacopoeia Phase
Treatment Phase
ADMISSIONS PHASE
The center of the table is referred to as the Ward.
Take the top card of the Patient deck and place it face up in the Ward.
(This is the newest admission)
Note: As the game proceeds, there will be more and more admits.
Maximum patient population in the ward is 8 patients.\
If there are already 8 patients in the Ward, skip this phase.
PHARMACOEIA PHASE
Draw 3 cards from the Treatment deck and put them in your hand.
If the deck runs out, shuffle the discard and draw from it.
Max hand size is 8 cards. Discard excess cards.
TREATMENT PHASE
Discard any Treatment cards from your hand you don’t want.
You may attempt to treat a patient by playing an appropriate Drug
card from your hand onto that Patient.
Your opponents may play (discard) an appropriate Contraindication Card to
cause a target Drug card to be discarded.
If you meet all the treatment requirements of a patient, put that patient
Card into your File (A pile next to you).
Some patients require 2-3 Drug cards for successful treatment; It is possible
That a patient may be partially treated. In this case, the Drug cards remain
On the patient from turn to turn. The player who finishes the treatment gets to
keep the Patient for his or her file.
One a patient goes to a File, discard all Drug cards on the patient.
During your turn you may play multiple Drug cards and treat multiple patients.
PATIENT DECK CARD LIST
Patient Disorder: Notes (Treatment Requirements)
Paranoid Schizophrenia Treat with 1 drug for SZ
Catatonic Schizophrenia Treat with 1 drug for SZ
Disorganized Schizophrenia Treat with 1 drug for SZ
Undifferentiated Schizophrenia Treat with 1 drug for SZ
Residual Schizophrenia Treat with 1 drug for SZ
Schizo-affective Disorder Treat with 1 drug for SZ & 1 for BP
Psychotic Break Treat with 1 drug for SZ & 1 BNZ
Psychosis Treat with 1 drug for SZ & 1 BNZ
Violent Outbursts Treat with 1 drug for SZ & 1 BNZ
Major Depression Treat with 1 drug for DP [2]
Dysthymia Treat with 1 drug for DP
Double Depression Treat with 2 drugs for DP
Suicidal Ideation Treat with 2 drugs for DP
Self Mutilation (Cutter) Treat with 1 drug for DP
Depression with Psychotic Features Treat with 1 drug for DP & 1 for SZ
Social Phobia Treat with 1 drug for AX
Anxious Depression Treat with 1 drug for DP & 1 for AX
Generalized Anxiety Disorder Treat with 1 drug for AX [2]
Panic Attacks Treat with 3 drugs for AX
Obsessive-compulsive Disorder Treat with 2 drugs for OCD [2]
Post-traumatic Stress Disorder Treat with 1 drug for AX
Manic Depressive Treat with 1 drug for BP
Mixed Bipolar Treat with 1 drug for BP
Manic Episode Treat with 1 drug for BP & 1 BNZ
Depressive Bipolar Treat with 1 drug for BP
Cyclothymia Treat with 3 drugs for BP
Seasonal Affective Disorder Treat with 1 drug for BP
Dyssomnia Treat with 1 drug for SD
Insomnia Treat with 1 drug for SD [2]
Alcoholic Detox Treat with 1 BNZ
Benzo Detox Treat with 1 BNZ
Opiate Detox Treat with 1 ODT
Poly Substance Abuse Treat with 1 BNZ & 1 ODT
SZ = Schizophrenia
BP = Bipolar
DP = Depression
AX = Anxiety
OCD = Obsessive-compulsive Disorder
SD = Sleep Disorder
BNZ = Benzodiazepines
[X] = Number of that card in the deck
DRUG CARDS (THE TREATMENT DECK) CARD LIST
Drug Class SZ AX DP BP OCD SD
Ativan BNZ - 1 C 3 - 1
Xanax BNZ - 1 C 3 - 1
Halcion BNZ - 1 C 3 - 1
Valium BNZ - 1 C 3 - 1
Librium BNZ - 1 C 3 - 1
Dalmane BNZ - 1 C 3 - 1
Restoril BNZ - 1 C 3 - 1
Serax BNZ - 1 C 3 - 1
Clonazepam BNZ - 1 C 3 - 1
Tranxene BNZ - 1 C 3 - 1
Phenobarbital BRB - 3 C - - 2
Atarax AH - 3 - - - 1
Prozac SSRI - 1 1 C 1 -
Zoloft SSRI - 1 1 C 1 -
Paxil SSRI - 1 1 C 1 -
Luvox SSRI - 1 1 C 1 -
Celexa SSRI - 1 1 - 1 -
Lexapro SSRI - 1 1 - 1 -
Wellbutrin AAD - - 1 1 - -
Bupropion AAD - - 1 1 - -
Effexor AAD - 1 1 - - -
Serzone AAD - - 1 - - 2
Remeron AAD - - 1 - - 2
Trazadone AAD - - 1 - - 1
Phenelzine MAOI - - 3 - 3 -
Tranylcypromine MAOI - - 3 - 3 -
Buspar AAX - 1 3 - 2 -
Ambien HYP - - - - - 1
Sonata HYP - - - - - 1
Elavil TCA - - 2 - 2 3
Clomipramine TCA - - 2 - 1 3
Amoxipine TCA - - 2 - 2 3
Doxepin TCA - - 2 - 2 3
Imipramine TCA - - 2 - 2 3
Pamelor TCA - - 2 - 2 3
Lithium MS - - 3 1 2 -
Lithobid MS - - 3 1 2 -
Depakote MS - - - 1 - -
Valproic Acid MS - - - 1 - -
Tegretol MS - - 3 1 - -
Carbamazepine MS - - 3 1 - -
Lamotragine AAC - - - 2 - -
ECT ECT - - 1 - - -
Haldol TAP 1 - - 2 2 -
Thorazine TAP 1 - - 2 - -
Prolixin TAP 1 - - 2 - -
Stelazine TAP 1 - - 2 - -
Zyprexa AAP 1 - - 1 C -
Olanzapine AAP 1 - - 1 C -
Clozaril AAP 2 - - 3 C -
Geodon AAP 1 - - 1 C -
Seroquel AAP 1 - - 1 C -
Quetiapine AAP 1 - - 1 C -
Risperdal AAP 1 - - 1 C -
Risperidone AAP 1 - - 1 C -
Herbal Medication - - 3 3 - - 2
Behavioral Therapy BT 3 3 3 3 3 3
Clonidine ODT
Methadone ODT
Naltrexone ODT
1 = First Line Indicated (Drug of Choice)
2 = Second Line Drug
3 = Third Line Drug
C = Contraindicated (= Do not use)
SSRI = Selective Serotonin Reuptake Inhibitor
AAD = Atypical Antidepressant
MAOI = Monamine Oxidase Inhibitors
AAX = Atypical Anxiolytic
HYP = Hypnotic
BRB = Barbiturate
AH = Antihistamine
TAP = Typical Antipsychotic
AAP = Atypical Antipsychotic
MS = Mood Stabilizer
ECT = Electroconvulsive Therapy
AAC = Atypical Anticonvulsant
ODT = Opiate Detox
BT = Behavioral Therapy is 2nd line for all Detox patients
SECOND AND THIRD LINE DRUGS
You cannot treat with a 2nd line drug until another drug has been used or tried.
You cannot treat with a 3rd line drug until 2 other drugs have been used or tried.
CONTRAINDICATION CARDS (THE TREATMENT DECK) CARD LIST
Contraindication: Target Drug Cards:
Addiction BNZ, BRB
Overdose TCA, BRB, LI
Sexual Dysfunction TCA, SSRI, MAOI, AAD
Seizures Buproprion, TCA
Anticholinergic effects TCA, AH, MAOI, Serzone
Refractory Disease State Any
Drug Resistance Any
Tolerance Any
Drug Allergy Any
Dermatological effects TCA, AAP, TAP, MS
Anterograde Amnesia BNZ
Paradoxical Excitement BNZ
Dizziness BNZ, BRB, Remeron
Withdrawal Symptoms BNZ
Sedation BNZ, TCA, Li, Paxil, Phenelzine
Activating SSRI (not Paxil)
Autonomic Side Effects TCA
Cardiac Side Effects TCA, Li, Effexor
Weight Gain TCA, Remeron, Li, AAP
Weight Loss (Anorexia) SSRI, Effexor
SIADH TCA, SSRI
Compliance Issues Any
Precipitate Mania TCA
Hypertensive Crisis MAOI
Serotonin Syndrome MAOI
Anxiety SSRI
Nausea SSRI, AAD, AAX
Comorbid COPD BNZ
Comorbid Eating Disorder Buproprion
Priapism Trazadone
Orthostasis TCA, Trazadone, Effexor, Risperdal
Nephrogenic Diabetes Insipidis Li
Hematologic effects Valproic Acid, Tegretol, AAP
Dystonia TAP
Pseudoparkinsonism TAP
Akathesia TAP
Tardive Dyskinesia TAP
Neuroleptic Malignant Syndrome TAP
Interaction: Cimetidine BNZ
Comorbid Alcoholic BNZ, BRB
Interaction: OTC Decongestants MAOI
Interaction: NSAIDS Li
Underdosage Any
Therapeutic Failure Any
Gynecomastia TAP
Agranulocytosis Clozaril
Comorbid Personality Disorder Any
Not covered by Insurance Any
Misdiagnosis Shuffle patient back into deck
Transferred Shuffle patient back into deck