SEARCH · PubMed Health

Results for “PSYCHOSES, TOXIC”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources

PubMed1981

The use of lisuride in the treatment of multiple system atrophy with autonomic failure (Shy-Drager syndrome).

In a controlled trial lisuride, an ergolene derivative with dopamine receptor agonist properties was given maximum tolerated doses (2.4 mg/day) to seven patients with multiple system atrophy with autonomic failure (Shy-Drager syndrome). Improvement in Parkinsonian features occurred in only one patient and another patient who had been deriving marked benefit from levodopa treatment before the study began failed to respond to large doses of lisuride. Psychiatric side effects (including nightmares, isolated visual hallucinations and toxic confusional states) were the dose-limiting factor in six patients. A modest reduction in orthostatic hypotension occurred in two patients, one of whom had experienced an aggravation of this disturbance on levodopa and bromocriptine. Destruction of post-synaptic dopamine receptors and damage to central noradrenergic systems may offer an explanation for the lack of therapeutic effect of lisuride.

Adult↗

PubMed1977

Clinical pharmacology of phencyclidine toxicity.

Phencyclidine appears to be unique in action compared with other psychedelic drugs, and its effects are less dependent upon the individual's personality than are the effects of LSD or mescaline. The authors discuss the sensory, psychological, and behavioral symptoms of phencyclidine intoxication. Most cases are of short duration and the only treatment necessary may be observation together with minimal stimulation and diazepam. However, prolonged and severe behavioral disturbances, exaggeration of preexisting thought disorder, and serious medical complications commonly occur and must be considered in the treatment plan.

Cognition↗

PubMed1982

Diazepam withdrawal syndrome: its prolonged and changing nature.

The diazepam withdrawal syndrome was studied in 10 patients who had abused the drug for 3 to 14 years. In the previous 6 months their consumption of diazepam had ranged from 60 to 120 mg daily; none had used other drugs during this period. The withdrawal period lasted about 6 weeks. The intensity of the symptoms and signs was high initially, fell during the first 2 weeks, then rose again in the third week, before finally declining. Three groups of symptoms and signs were identified. Group A symptoms occurred throughout withdrawal and included tremor, anorexia, insomnia and myoclonus. Group B symptoms and signs were largely confined to the first 10 days and were those of a toxic psychosis. Group C symptoms reached a peak in the third and fourth weeks of withdrawal and were characterized by sense perceptions that were either heightened or lowered. The symptom groups, the presence of tremor and myoclonus, and the relief of symptoms by a test dose permit diazepam withdrawal to be distinguished from anxiety. The biphasic course of the symptoms is probably related to the pharmacokinetics of diazepam.

Adult↗

PubMed1995

Convulsive therapy in delusional disorders.

Delusions are psychopathologic expressions associated with schizophrenia, affective disorders, and systemic and toxic illnesses. In each condition, the efficacy of ECT is well defined. For some illnesses, such as major depression with psychosis, manic delirium, and catatonia, ECT is effective in relieving the delusional states. This activity of ECT as an antidelusional agent compels us to consider the mode of action of ECT as broader than as an antidepressant treatment alone. The experience also compels greater consideration of the unitary classification of severe mental disorders.

Delusions↗

PubMed1976

[Neurological and psychiatric disorders following acute arsine poisoning (author's transl)].

Follow-up study of 6 workers, who after survival of an acute arsine poisoning, developed psychopathologic and neurologic abnormalities. The symptoms appeared after a latency of 1 to 6 months indicating a toxic polyneuropathy and a mild psycho-organic syndrome. The severity of these reversible manifestations was directly related to the period of time of exposure to arsine. The clinical picture of arsine polyneuropathy was similar to that observed in arsenic poisoning, suggesting that arsine polyneuropathy is due to the action of arsenic. The psychopathologic syndrome corresponds to the so-called "Vergiftungsspätfolgesyndrom" and therefore does not appear to be a specific sequel of arsine poisoning.

Adult↗

PubMed2000

Corticosteroid-induced adverse psychiatric effects: incidence, diagnosis and management.

Reports of corticosteroid-induced adverse psychiatric effects began to appear in the literature soon after the introduction of these medications in the 1950s. Unfortunately, early studies relied on informal classification and measurement procedures and tended to utilise nonspecific descriptive terminology (such as steroid psychosis'). A growing number of contemporary investigations have begun to address these problems. However, the literature remains surprisingly undeveloped from a pharmacoepidemiological perspective, consisting largely of case reports and case series. The objective of this review is to summarise published data concerning corticosteroid-induced adverse psychiatric effects. A clinical perspective will be adopted since opportunities to minimise the impact of corticosteroid-induced adverse effects tend to present themselves most readily within the sphere of clinical management. Some of the psychiatric adverse effects of corticosteroids are mild, and not necessarily clinically significant. However, several serious psychiatric syndromes can be caused by corticosteroids: substance-induced mood disorders (with depressive, manic and mixed features), substance-induced psychotic disorders and delirium. While certain clinical groups may be at greater risk of corticosteroid-induced adverse psychiatric effects, corticosteroid-induced psychiatric toxicity is remarkably unpredictable. The literature regarding prevention and treatment of corticosteroid-induced adverse psychiatric effects is poorly developed. As a result, the emphasis of this review is on clinical and epidemiological evidence linking specific adverse effects to corticosteroid medications. However, clinical reports do provide some practical guidance for prevention and treatment, and these are summarised as well. A variety of pharmacological strategies for treatment and prevention have been proposed. Education and support also appear to be important, and perhaps neglected.

Adrenal Cortex Hormones↗

PubMed1995

Toxic psychosis: an unusual presentation of propranolol intoxication.

Timely diagnosis of acute propranolol intoxication requires a high index of suspicion and a knowledge of the multiple ways in which these patients may present to the emergency department. We report a case of severe propranolol intoxication that presented as an acute psychotic episode preceding cardiovascular decompensation and seizures by several hours. Though acute reversible psychosis has been appreciated after initiating or increasing propranolol dosage therapeutically, this association has not been reported in the literature regarding beta blocker overdose or intoxication. Propranolol psychosis and several other pertinent aspects of this case are discussed.

Acute Disease↗

PubMed1993

Delayed extinction of executive sets associated with decreased cholinergic function: a mechanism of perseverative and intrusive behavior.

Perseverative and intrusive behavior were studied in three psychiatric patients with toxic dementia associated with anticholinergic drugs. A mechanism was proposed attributing these behaviors to the delayed extinction (residual activation) of prior executive sets (or schema) in the context of sets containing nondissociated operations. Reutilization of these operations appeared to trigger the nonextinguished set back into executive status. It was hypothesized that set perseveration and intrusion reflect a defect in the set-scheduling process induced by loss of cholinergic function.

Antiparkinson Agents↗

PubMed1987

Disturbed behaviour in dementia--psychiatric or medical problem?

A retrospective clinical analysis of 70 demented patients who were admitted with disturbed behaviour to an acute psychogeriatric assessment and treatment centre revealed that 34.4% of patients had a significant untreated physical illness, 8.5% of patients were suffering from drug-induced toxicity and 11.4% of patients had a superimposed psychiatric illness. In only 39% of patients was progressive dementia alone considered an adequate explanation for their behavioural disturbance. The condition of the majority of patients improved significantly and they returned to the community. This study suggests that all patients with dementia with disturbed behaviour should be assessed carefully. In the majority, a clear treatable cause can be found and a good response can be attained with appropriate management.

Aged↗

PubMed1983

Cocaine uses and abuses.

Cocaine is a time-honored topical anesthetic for intranasal surgery. It combines superb anesthesia with constriction of nasal vasculature and patient euphoria, which facilitates surgery and enhances its tolerability to the patient. Dosages of 200 mg (2 ml of 10% solution) are considered safe and effective for surgical anesthesia. Central nervous system excitability is the predominant toxic reaction followed by convulsions and apnea, which require respiratory support. Intravenous diazepam effectively averts this reaction. Cardiovascular toxicity appears at higher dosages (such as with ingestion for concealment during smuggling) or when epinephrine is concurrently used with cocaine. Cocaine is also damaging to nasal membranes and the nasal septal cartilage, due to its vasoconstrictive effect and the irritative effects of its diluting contaminants. Its major psychological effect is stimulation similar to that of the amphetamines. Prolonged recreational use may lead to paranoia and violent, antisocial behavior, including homicide and suicide.

Administration, Intranasal↗

PubMed1995

Haloperidol dose and blood level variability: toxicity and interindividual and intraindividual variability in the nonresponder patient in the clinical practice setting.

Haloperidol levels in blood were measured monthly in 43 refractory chronic schizophrenic patients referred to a locked skilled nursing facility for long-term treatment. Gross toxic side effects (seizures, catatonia, confusion) and Neuroleptic Induced Deficit Syndrome in conjunction with blood levels over 30 ng/ml were identified in 13 of our 43 patients. Blood level reductions contributed to a reduction of side effects and clinical improvement and led to the expedited discharge of 6 of these 13 patients of the toxic subgroup. Considerable blood level variation was evident in single samples, and four levels appeared necessary to develop confidence for accuracy. Significant dose to blood level interindividual variability was identified, thereby bringing into question fixed-dose approaches to patients. The results strongly suggest the utility of haloperidol blood levels in the clinical setting.

Administration, Oral↗

PubMed1993

Is aluminium an etiologic contributor to alcoholic amnesia and dementia?

Neurotoxicity from excess brain exposure to aluminium (Al) is well-documented, from both clinical observations and animal experiments, to impair learning, memory and cognition. The etiology of the cognitive impairment in chronic abusers of ethanol--alcoholic amnesia or dementia--is not known, but it is likely to be multifactorial. We hypothesize that a slowly-progressive accumulation of Al in the brain, so as to reach functionally-toxic levels, may be one such factor. This could occur because of an increased permeability of intestinal mucosa to entry of Al, arising from sustained exposure of the gastrointestinal tract to alcoholic beverages, plus a trend for more frequent ingestion of antacids based on Al salts for treating gastritis or ulcers caused by such exposure. If this be true, use of Al-containing medications, as well as all avoidable exposures to Al, should be contra-indicated for chronic heavy drinkers.

Alcohol Amnestic Disorder↗

PubMed1981

Acute phencyclidine intoxication: clinical patterns, complications, and treatment.

We describe four major and five minor clinical patterns of acute phencyclidine (PCP) intoxication and give the incidence of findings in each pattern. Major patterns were acute brain syndrome (248 cases; 24.8%), toxic psychosis (166 cases; 16.6%), catatonic syndrome (117 cases; 11.7%), and coma (106 cases; 10.6%). Minor patterns included lethargy or stupor (38 cases; 3.8%), and combinations of bizarre behavior, violence, agitation, and euphoria in patients who were alert and oriented (325 cases; 32.5%). Patients with major patterns of PCP toxicity usually required hospitalization and accounted for most complications. In general, patients with minor patterns had mild intoxication and did not require hospitalization except for the treatment of injuries or autonomic effects of PCP. Various types of injuries occurred in 16%, and aspiration pneumonia occurred in 1.0% of all cases. There were 22 cases of rhabdomyolysis (2.2%), with three patients requiring dialysis for renal failure. One patient who had been comatose from PCP died suddenly. A fresh pulmonary embolism was found at autopsy.

Catatonia↗

PubMed1994

Anticholinergic syndrome. Avoiding misdiagnosis.

Anticholinergic syndrome can develop in multiple clinical situations. The disturbance of the central nervous system muscarinic transmission by acetylcholine antagonists or lack of acetylcholine can result in this unpredictable behavioral syndrome. Health care professionals should do the following: Be familiar with common drugs or drug combinations that may induce this condition; Be aware of patients who may be at greatest risk; Be able to identify the cluster of signs and symptoms of anticholinergic toxicity; and Implement appropriate nursing treatment interventions for patients with anticholinergic syndrome. Because this condition is constantly changing, it often is misdiagnosed. Much remains to be studied and understood about the neurophysiology of this condition. Central cholinergic transmission is blocked with the use of many anticholinergic drugs in numerous patient settings. Because acetylcholine plays a significant role in modulating the interactions among most other central transmitters, excessive blockage of this neurotransmitter may result in the unpredictable behavioral condition known as anticholinergic syndrome.

Adolescent↗

PubMed1983

Psychiatric reactions during tricyclic treatment of the elderly reconsidered.

In a prospective study of all geriatric patients treated with tricyclic antidepressants over an 18-month period, a lower incidence of adverse psychiatric reactions than literature based on chart reviews has suggested was found. In only three of the 43 patients studied (7%) did a picture consistent with toxic delirium develop. None of the seven patients with senile dementia of the Alzheimer type suffered an adverse psychiatric reaction despite having achieved therapeutic blood levels of medication. Difficulties in determining the type and pathogenesis of untoward reactions that do occur as a source of error in establishing frequency are emphasized. The relationship of such reactions to the neurobiology of aging, the central anticholinergic syndrome, and the putative role of acetylcholine in contributing to the clinical picture of senile dementia of the Alzheimer type is discussed.

Aged↗

PubMed1989

Toxic ictal delirium.

Delirium, also known as acute confusional state, is a common reversible organic psychiatric syndrome. This paper focuses on toxic delirium associated with prominent paroxysmal electroencephalogram (EEG) dysfunction occurring in nonepileptic patients. Our data derive from observations in two conditions, viz., delirium induced by hypnosedative drug withdrawal and confusion activated by psychotropic drug overdosage. It is suggested that in these conditions, delirium represents a generalized symptomatic nonconvulsive epileptic state following a transient transmitter dysfunction. Dramatic relief of both clinical and EEG dysfunction by intravenous benzodiazepines is reported in detail. Finally, the informative value of the EEG in the differential diagnosis of acute confusional states is emphasized.

Adult↗

PubMed1988

Cyclosporin neurotoxicity in cardiac transplant recipients.

Cyclosporin toxicity may produce a wide range of neurological disorders. We report three patients whose neurological problems developed while taking cyclosporin following cardiac transplantation, but resolved rapidly when the drug was discontinued. In two cases, MRI revealed abnormalities which disappeared with clinical recovery. Blood cyclosporin concentrations were not markedly increased, and it is possible that the neurotoxic effects of cyclosporin are mediated by metabolites, through an effect on the blood-brain barrier.

Adolescent↗

PubMed1984

Marijuana. Health and treatment issues.

Intermittent use of low-potency cannabis is not generally associated with obvious toxicity. In recent years, some cannabis users have been using high doses more frequently and seeking treatment. A large but incomplete literature indicates that cannabis can be harmful to health, and that virtually every system in the body is affected by cannabis. Cannabis pharmacology is complex; all recent scientific groups reviewing cannabis conclude it is clearly capable of causing adverse effects to health. Specific treatment procedures have not been developed for managing cannabis related problems. Strategies useful in treating other drug dependence problems are useful in treating dependence.

Brain↗