Drug points: Drug induced psychosis with doxazosin

Evans, Mdr; Perera, Pradilka; Donoghue, J.

doi:10.1136/bmj.314.7098.1869

Cited by 11 publications

(2 citation statements)

References 2 publications

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“…Reported adverse effects have included nausea, drowsiness, dry mouth, sweating, dizziness, muzziness, trembling, and sedation 4. Auditory hallucinations have been reported in association with pentoxifylline5 and doxazosin 6…”

Section: Discussionmentioning

confidence: 99%

Hear my song: auditory hallucinations with tramadol hydrochloride

Keeley¹,

Foster²,

Whitelaw³

2000

BMJ

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Tramadol hydrochloride is a weak opioid with effects on seratoninergic and adrenergic neurotransmission. 1 It is reported to have fewer opioid adverse effects than conventional opioid analgesia. 2 We report an unusual but important adverse effect not previously reported with the drug. Case reportA 74 year old man with lung cancer was referred to the palliative care team for symptom control. He had pain in the left side of his chest and was advised to take tramadol hydrochloride 50 mg four times daily at home. Soon after starting the tramadol, he began to experience auditory hallucinations. These were particularly vivid and took the form of "two voices singing, accompanied by an accordion and a banjo, singing songs, songs by Josef Locke-old songs." They were distressing, making him feel as though he was going mad. Because of these symptoms we admitted the patient for inpatient care.He was also taking aspirin 75 mg, digoxin 250 g, prednisolone 15 mg, frusemide 40 mg, omeprazole 20 mg, and codanthramer 20 ml, each once daily, and Voltarol 75 mg twice daily, and he was using a Combivent (salbutamol/ipratropium) nebuliser 2.5 ml four times daily, but all these had been unchanged for some weeks before the onset of the auditory hallucinations. The patient had no other adverse effects or signs of toxicity attributable to opioids.We discontinued the tramadol and instead gave two tablets of co-proxamol (dextropropoxyphene 32.5 mg, paracetamol 325 mg) four times daily, with which his cancer pain was well controlled. Two days later the hallucinations ceased. A computed tomographic brain scan around the time of admission showed only established diffuse ischaemic change with no major focal cerebral lesion. There was no history of hallucinations or mental illness. We reported this adverse reaction to the Committee on Safety of Medicines through the yellow card scheme.

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Section: Discussionmentioning

confidence: 99%

Hear my song: auditory hallucinations with tramadol hydrochloride

Keeley¹,

Foster²,

Whitelaw³

2000

BMJ

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“… 185 Sleep disturbance and anxiety can occur with these agents, though such symptoms are usually mild 186 , 187 ; there has been a single case report of psychosis associated with doxazosin. 188 Finally, aside from a small case series describing encephalopathy in three patients with endstage renal disease, 189 α 1 antagonists have not been frequently implicated in the development of delirium, and a study of nonelderly patients found that prazosintreated patients performed slightly better on cognitive testing than did patients given hydrochlorothiazide (HCTZ) or propranolol. 190 …”

Section: α-Adrenergic Agentsmentioning

confidence: 99%

Neuropsychiatric consequences of cardiovascular medications

Huffman

Stern²

2007

Dialogues in Clinical Neuroscience

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The use of cardiovascular medications can have a variety of neuropsychiatric consequences. Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs. Depression has been associated with P3-blockers, methyldopa, and reserpine, but more recent syntheses of the data have suggested that these associations are much weaker than originally believed. Though low cholesterol levels have been associated with depression and suicide, lipid-lowering agents have not been associated with these adverse effects. Finally, cardiovascular medications may have beneficial neuropsychiatric consequences; for example, the use of clonidine in patients with attention deficit-hyperactivity disorder, the use of prazosin for patients with post-traumatic stress disorder; and the use of propranolol for performance anxiety and akathisia.

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Doxazosin

2006

Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions

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Drug points: Drug induced psychosis with doxazosin

Cited by 11 publications

References 2 publications

Hear my song: auditory hallucinations with tramadol hydrochloride

Hear my song: auditory hallucinations with tramadol hydrochloride

Neuropsychiatric consequences of cardiovascular medications

Doxazosin

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