Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, June 18, 1990 TAG: 9006160344
SECTION: EXTRA PAGE: E1 EDITION: METRO
SOURCE: Jane Brody
DATELINE: LENGTH: Medium
When his medication was changed, these symptoms disappeared and his depression lifted.
Not everyone who experiences behavioral abnormalities,memory loss or intellectual deterioration as an unintended result of medication is as lucky.
The relationship between a prescribed drug and psychiatric symptoms often goes undetected, and an adverse drug reaction may be misdiagnosed as mental illness or senility. Additional medications may then be prescribed, often making matters even worse.
The problem is especially common in the elderly, who can suffer toxic reactions to doses that are harmless to younger people. Since older people are often "expected" to show signs of emotional or intellectual impairment, such symptoms may not be linked to the medication.
S. Clifford Rogers, a British physician, has noted that young people can also suffer devastating drug-induced psychiatric reactions that may not be readily recognized by patient or physician.
For example, when Valium-type drugs are given to mothers suffering from postpartum depression and delusions, the result can be battered babies: These drugs can cause the women to lose control of their aggressive feelings. Similarly, aggressive reactions can occur when these drugs are prescribed for people with schizophrenia or epilepsy.
Previous studies showed that even a single dose of Valium and related drugs could impair learning and psychomotor function, and that the effects can last for up to 60 hours.
Psychiatric symptoms may result from scores of medications, ranging from antibiotics and antihistamines to heart stimulants and painkillers.
For example, a host of cognitive side effects have been linked to methyldopa (Aldomet) and the beta-blocker propranolol hydrochloride (Inderal), medications commonly used to treat high blood pressure. Among the reported adverse effects are memory loss, fatigue, sedation, nightmares, insomnia, visual or auditory hallucinations,depression, psychoses and a decline in mental acuity.
Other cardiovascular drugs can also cause toxic effects on the brain. The heart stimulant digitalis, for example, can produce disorientation,irritability, agitation, delusions and hallucinations. Lidocaine, commonly used to regulate erratic heart rhythms, can result in excitement, agitation, restlessness,apprehension and depression.
Recognition of a drug-induced emotional disorder can be confused or delayed because similar symptoms may be associated with the disease being treated.
For example, patients with systemic lupus erythematosus,an autoimmune disorder, can experience emotional problems caused by their disease and/or by the corticosteroids usually prescribed to control the symptoms.
Several useful preventives, including cimetidine (Tagamet), used to prevent flare-ups of peptic ulcer, can set off toxic psychiatric reactions in some people.
Another common problem involves combinations of drugs. One drug used alone may be no problem, but trouble results when another medication is added that has a similar toxic effect or that can trigger the toxicity of the first drug.
To reduce the risk or speed recognition of psychiatric reactions to prescribed medications, three measures are critical:
Provide every physician who gives you medication with a complete list of all drugs, both prescription and over-the-counter medications, you are now using. If you do not know the names of all the drugs, bring the vials with you so the doctor can look them up.
While you are taking a medication, if you or your family notices any untoward emotional or behavioral symptoms - from irritability and memory lapses to depression and hostility - report it immediately to the prescribing physician.
Do not assume that the symptom is unrelated to the medication because you have taken the drug before with no adverse effects. Toxicities can build with long-term use, and sensitivities to medications can change with age and medical condition.
Even if the doctor doubts that the medication is the cause of your symptoms, suggest a trial of a different drug or a temporary drug-free period to see if the problem clears up.
by CNB