Adverse Drug Reactions (ADRs)
The British Medical Journal (BMJ) published an article in Clinical Updates
ADVERSE DRUG REACTIONS - together with an interview with the author Dr Robin Ferner.
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DR FERNER, EXPLAINS WHAT A BLACK TRIANGLE DRUG IS...
Also about the Yellow Card system of reporting.
The West Midlands ADR Reporting Centre at the Comittee on Safety of Medicines, now called the MHRA. Produced useful statistics. These publications are from many years ago when the WMCSM were permitted to do their own analysis of Yellow Card ADR reports they received. Sadly this is not longer the situation it seems.
Prescribed Drug Induced Depression
Prescribed Drug Induced Hallucinations
Some Psychiatric Effects: list modified from McConnell and Duffy, 1994 A list included in the Maudsley & Bethlem Hospital directory used by the health professionals in this psychiatric hospital
| Drug | Psychiatric Effects |
| Antihypertensive drugs | |
| Clonidine | depression, mania, agitation |
| Propanolol | depression, mania, delirium, psychosis |
| Nifedipine | depression |
| Captopril | mania, agitation |
| Antiarrhythmics | |
| Procaninamide | depression, mania, delirium, psychosis |
| Lignocaine | depression, delirium, psychosis |
| Disopyramide | delirium, psychosis |
| Antimicrobial Agents | |
| Penicillins | depression, agitation, visual halucinations |
| Tetracycline | depression, hallucinations |
| Cephalosporins | delirium, psychosis |
| Antimalarials | psychosis, visual hallucinations |
| Antiparkinson drugs | |
| Anticholinergics | delirium, psychosis, visual hallucinations, dementia |
| Amantadine | depression, agitation, delirium, psychosis visual hallucinations |
| Levodopa | depression, mania, anxiety, agitation, psychosis visual hallucinations, delirium, cognitive impairment |
| Antihistamines | |
| H1 Blockers (diphenhydramine) | delirium |
| H2 Blockers (cimetidine) | depression, mania, delirium, psychosis, visual hallucinations |
| Antineoplastic drugs | |
| Interferon | depression, agitation, delirium |
| Vincristine | depression |
| C-asparaginase | depression, delirium, psychosis |
| Endocrine Agents | |
| Corticosteroids | depression, mania, psychosis, delirium |
| Oral contraceptives | depression |
| Thyroxine | anxiety, agitation, mania, psychosis, visual hallucinations |
| Antiepileptic drugs | |
| Barbiturates (phenobarbitone, primidone) | hyperactivity (especially in children), sedation, sexual dysfunction, aggression, learning deficits, cognitive impairmant, depression, personality change Positive effects: anxiolytic/hypnotic (hypnotic, or soporific drugs produce sleep by depressing brain function and often cause hangover effects in the morning) |
| Benzodiazepines: (clonazepam, diazepam) | aggression, confusion, depression, disinhibition, irritability, cognitive impairment Positive effects: anxiolytic/hypnotic; antimanic (clonazepam) |
| Carbamazepine | depression, irritability, sexual dysfunction, mania Positive effects: antidepressant, antimanic, treatment of aggression and bipolar disorder |
| Clobazam | similar side effect profile to other benzodiazepines but may have lower overall incidence of cognitive and behavioural side effects anxiolytic/positive psychotropic effects |
| Gabapentin | sedation, ataxia, (shaky movements) aggression and hyperactivity (children); Few drug interactions, positive psychotropic effects, |
| Hydantoins (phenytoin) | sedation, ataxia, dementia, affective disorder, confusion, cognitive impairment, progressive encephalopathy (disease that affects functioning of the brain) Positive effects? antiaggressive, anxiolytic effects |
| Lamotrigine | may have added toxicity when used with carbamazepine: ataxia, dizziness; positive psychotropic effects |
| Succinimides (ethosuximide, methsuximide) | Psychosis ("alternating psychosis"- adolescents, young adults) Drowsiness, insomnia, irritability, cognitive effects, personality change, Positive effects: improvement in attention/concentration (likely related to seizure improvement) |
| Topirimate | sedation, confusion, cognitive dysfunction, asthenia (weakness loss of strength) |
| Valproate | progressive encephalopathy, dementia, depression, extrapyramidal effects (muscle spasms etc) Positive effects: antimanic, treatment of aggression and bipolar disorder |
| Vigabatrin | depression and psychosis |
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