Confusional Episodes and Antidepressant Medication

Epileptic Attack, Delirium, and a Creutzfeldt-Jakob-Like Syndrome during Mianserin Treatment

“…The second case, however, suggests that dysfunction in the noradrenergic or serotoninergic neurons may be responsible for the diffuse background slowing and synchronous periodic complexes seen in the EEG. This is in line with previous observations which suggest that slowing of EEG and even rhythmic slow complexes may also appear without major cholinergic blocking [17], Delirium is a known side effect of antidepressants especially at the beginning of treatment [1,18,19]. This was also the case in our patients despite the therapeutic plasma level in the second case.…”

Acute Delirious Syndromes due to Psychotropic Drugs

“…There are only few comparable data (5,8): some of the reports show a higher incidence which may be due to a relatively selective sampie of patients. There was no difference in risk far male or female patients in tbis study, while other authors found a preponderance of men (I) or women (2). As to age groups, there was a tendency towards the more elderly patients in the ADR group which is consistent with other reports (1,2,4,5); nevertheless, as 45 % of our patients were under 50 years, age cannot be estimated as a very important factor.…”

“…There was no difference in risk far male or female patients in tbis study, while other authors found a preponderance of men (I) or women (2). As to age groups, there was a tendency towards the more elderly patients in the ADR group which is consistent with other reports (1,2,4,5); nevertheless, as 45 % of our patients were under 50 years, age cannot be estimated as a very important factor. Although delirium due to psychotropic drugs seems to show symptoms that are not as severe as seen in delirium tremens (3), almost three quarters of our patients showed vegetative symptoms.…”

Treatment Approaches to Mania

“…However, only decreased activity of acetylcholine produces delirium as evidenced by the delirium produced by various anticholinergic dmgs such as atropine, sleeping medications, scopalamine (Bernstein and Leff, 1967;Holzgirafe et al, 1973;Smiler et ai, 1973) antiasthmatics (Gowdy, 1972;Hussain, 1971), and antiparkinsonian agents (Ananth and Jain, 1973). On the other hand, antidepressants can produce either delirium (Davies et al, 1971;Noble and Mathew, 1969) or manic psychosis in depressed patients. Theoreti cally, such a polarity can be explained by the fact that only anticholinergic activity, especially early in treatment, cause delirium, while increased NE, because of blockade of reuptake, in addition may cause mania.…”