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At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

Dextromethorphan- and pseudoephedrine-induced agitated psychosis and ataxia: case report.

Pseudoephedrine and dextromethorphan are therapeutic constituents of numerous commonly used, over-the-counter cough and cold preparations. Although this drug combination is generally considered quite safe if utilized in recommended doses, overmedication or overdose can result in serious neurologic and cardiovascular abnormalities that occasionally can be life-threatening. We present a case of a 2-year-old child who developed hyperirritability, psychosis, and ataxia after being overmedicated with a pseudoephedrine/dextromethorphan combination cough preparation, and discuss probable mechanisms of toxicity and risk factors for adverse events.

Antitussive Agents↗
PubMed2006

Crystal crush.

Methamphetamine use has exploded in some unexpected regions of the country, including rural areas of the West and Midwest. The crisis is testing the capacity of hospital emergency departments and public health systems. For users, the initial euphoria from the drug quickly vanishes, with toxic effects on the brain and judgment control.

Adolescent↗
PubMed1988

Intravenous cocaine: psychiatric effects, biological mechanisms.

Volunteer addicts were administered iv loading doses of cocaine, followed by 4-hr cocaine infusions that maintained steady-state conditions. The loading doses were followed by the "rush" and "high" subjective effects that users typically experience; cocaine infusions maintained the experience of drug "high", but not "rush". In a subsequent experiment, haloperidol pretreatment did not alter cocaine "rush" but partially attenuated cocaine "high." During cocaine infusions, we also noted suspicious and paranoid behavior, which were blindly rated by nurses. During one of the infusion conditions, the degree of suspiciousness observed was related to the amount of cocaine previously administered. Although cardiovascular responses to cocaine were marked, we found no alterations in plasma catecholamines following cocaine administrations. Baseline homovanillic acid (HVA) levels, however, were related to the degree of suspiciousness observed following cocaine dosing. The potential contributions of dopaminergic systems and physiological sensitization to the development of the psychiatric toxicity of cocaine are discussed.

Adult↗
PubMed1983

[Features of catatono-oneiroid paroxysms of schizophrenia manifesting in the puerperal period].

A total of 131 puerperas with manifest paroxysms of schizophrenia were examined to correlate the time- course of their psychic and somatic state (puerperal characteristics and complications). Specific features of schizophrenia in the postpartum period were disclosed. The authors analyzed the course of manifest paroxysms (patients with predominant catatono-oneiroidal symptomatology) accompanied by pyrexia associated with acute endometritis, the subclinical forms of schizophrenia and also its course during an uncomplicated puerperium and correlated the clinical picture of psychoses in the presence of fever and without it. On the basis of the results obtained a suggestion is made that the febrile reaction accompanying manifest paroxysms of schizophrenia with predominant catatono-oneiroidal symptomatology cannot be considered as a manifestation of infection or as a manifestation of the toxic course of schizophrenia, inasmuch it reflects a particular state of the whole body and the CNS in the puerperium giving rise to the manifestations of schizophrenic process.

Adult↗
PubMedDate not supplied

An "accidental" acute psychosis with ecstasy use.

Over the last 10 years, Europe has witnessed the development of the ecstasy phenomenon; this term is used to describe several products sharing more or less the same effects. The most widely used and hence the most well known is 3,4 MDMA, but MDA, MDEA, MBDB and even 2CB or nexus are available. The psychopathological consequences of MDMA use in man are relatively poorly understood. The case reported here involves an acute psychotic episode with residual symptoms after six months, with a sudden onset at least 12 hours after taking alcohol and ecstasy without realising it, in an individual with no previous psychopathology other than a moderate anxiety disorder. Twelve cases of acute psychotic episodes after taking ecstasy have been reported in the literature; two after taking the drug on two occasions and one after a single use. No authors have examined the previous mental state or possible previous psychopathology with any precision. The present subject had not displayed any previous psychotic behavior when tested with a proven standardized interview technique; this was confirmed by his peers and his family. He did, however, show signs of social phobia. Although the personality of an individual is a factor in taking a drug, and probably in the quality of the psychotropic effects experienced, a host of arguments favor the appearance of psychotic symptoms de novo, which were probably related to direct toxicity by MDMA and/or its metabolites on the serotoninergic neurons.

Adult↗
PubMed1981

Adverse psychiatric reactions to modern medication.

From this survey it will be apparent that many psychiatric reactions to drugs are largely caused by their direct toxic actions or from combinations of drugs. As such, they are often dose related, although age and slow speed of detoxification will increase the risk of patients developing delirium, hallucinations, sleep disturbances, anxiety etc. Similar toxic reactions can also occur when drugs to which a patient has developed some measure of tolerance are abruptly withdrawn. In this context the effects of drugs upon patterns of sleep may be important determinants of adverse withdrawal symptoms. In contrast are the reactions which resemble one or other of the functional psychoses. In these patients it appears that a past history of an affective or schizophrenic psychosis is the best predictor of a similar illness being precipitated by a particular drug. Nonetheless, with substances like reserpine and cycloserine there is good reason for thinking that, given a sufficient quantity, practically any patient can develop an adverse psychiatric reaction.

Aged↗
PubMed2006

[Ecstasy toxicity].

The substance, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an amphetamine derivate. A mistaken belief that it is a safe drug of low toxicity and a long duration of action has led to its widespread popularity among teenagers and young adults in recent years. Unfortunately, ecstasy use has increased to epidemic proportions. In this review article pharmacokinetics and pathophysiology of MDMA, general medical adverse effects, cardiovascular effects, serotonin syndrome, hyponatremia, neurologic effects, hepatotoxicity, and long-term neuropsychiatric effects, clinical features of toxicity, prehospital and emergency department care problems, and mortality/morbidity, prophylactic advices are discussed.

Adolescent↗
PubMedDate not supplied

[Effect of abstinence on visual evoked potentials in alcoholics].

Visual evoked potentials (VEP) were studied in 61 alcohol-dependent subjects analysing the amplitude and latency of the first major positive wave (P100) and carrying out the determinations three times, in the 1st, 2nd and 3rd weeks of abstinence. The results were compared with similar ones obtained in healthy subjects without a history of alcohol abuse. In the acute stage of alcohol withdrawal a significant rise was observed in the amplitude of the cortical P100/N120 complex. With regression of the clinical symptoms of withdrawal syndrome the amplitude of visual potentials decreased and demonstrated partial normalization. The mean P100 latency was significantly longer in relation to the control group and was not changed during the withdrawal period. Amplitude increase was regarded as an evidence of hyperexcitability of the central nervous system, and latency prolongation as a result of the toxic effects of alcohol and nicotine on the optic nerve.

Acute Disease↗
PubMed1989

Psychotoxicology: the return of the mad hatter.

Psychiatrists have not been attentive to the huge and expanding capacity of neurotoxic substances to induce symptoms of emotional and behavioral dysfunction. The psychiatric implications of exposure to heavy metals, volatile solvents, pesticides and behavioral teratogens is reviewed. Case histories reflect the risk of misdiagnosing psychotoxic episodes and the futility of standard interventions. The variability of behavioral responses to psychotoxic agents challenges a psychiatric nomenclature based on specific disease categories. Psychiatrists should routinely inquire about exposure to toxic substances. The issues raised will result in confrontation with social and economic forces usually ignored by clinicians.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Marihuana psychoses].

Five chronic consumers of marihuana (through periods of 1 to 3 years) were studied and given a complete set of psychological tests (Rorschach, Wechsler, Phillipson, Psicodiagnóstico Miokinético). Brief case histories and tests results are presented for each subject. In all cases, marked depression, and anxiety, schizoid features, and poor control were detected. In four patients self-aggresion, inversion of sleep cycle, weakness of will and mental confusion were registered. In four subjects a definite psychotic profile was detected through Rorschach tests. Three patients suffered from visual hallucinations, and trends to sexual promiscuity. Memory failure and gaps were apparent in two cases. One patient developed a short-lasting paranoid delusion. Two patients showed no sign of abnormality in their E.E.G. The syndrome shows that marihuana abuse may lead to toxic psychosis similar to schizophrenia. The importance of a systematic use of complete sets of psychological tests is discussed, although their value for a differential diagnosis between toxic marihuana-psychosis and schizophrenia remains to be established. The need for careful search on marihuana abuse is emphasized. Regarding the physiopathology of marihuana-psychosis, some recent findings of neurochemistry are discussed, in particular those of biological theories of schizophrenia. This approach allows a parallel between both disorders. The possibility of both being accounted for by a common metabolic defect is suggested. Finally, the current contention that marihuana is harmless or innocuous is called to revision.

Adult↗