Citation

Ashton CH. Medicine (Abingdon) 2004; 32(8): 50-52.

Copyright

(Copyright © 2004, Medicine Publishing)

DOI

10.1383/medc.32.8.50.43169

PMID

unavailable

Abstract

Neuropsychiatric effects account for up to 30% of adverse drug reactions and can be caused by drugs administered for physical conditions in psychiatrically normal patients. Such reactions can include anxiety, depression, psychosis, mania, delirium, sleep disorders and hallucinations. They are more common in elderly or ill patients, though a psychiatric history may increase vulnerability. The reactions are sometimes dose-related, but can occur at therapeutic doses or on drug withdrawal. Drugs used for parkinsonism, cardiovascular, endocrine and gastrointestinal disorders, pain syndromes, and bacterial, parasitic or viral infections may all cause psychiatric effects. Such drugs include dopaminergic and antimuscarinic agents, digitalis preparations, β-adrenoceptor antagonists, glucocorticoids, sex hormones, anabolic steriods, H2-receptors antagonists, protein pump inhibitors, antibiotics, antimalarials, antiviral drugs and interferons. Management may be straightforward when the cause is recognized, but patients taking several drugs need careful assessment because adverse psychiatric effects can result from drug interactions.