Adverse Psychiatric Reactions Information Link

Promoting awareness of medicines that can harm mental health

Adverse Reactions (ADR) info

 

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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