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What are side effects of psychiatric medications?

Side effects and long-term impacts of mental health medications
 headaches.
 weight gain.
 dizziness.
 dry mouth.
 muscle spasms and cramps.
 nausea.
 loss of sex drive.
 constipation.
More items...

Managing mental health medications - Better Health Channel

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What are the two most common side effects of antipsychotic medications?
Possible side-effects of antipsychotics include:
 dry mouth.
 dizziness.
 weight gain that can lead to diabetes.
 blurred vision.
 movement effects (for example, tremor, stiffness, agitation)
 sedation (for example causing sleepiness or low energy)
 loss of menstrual periods in women.
 fluid retention.
More items...

Antipsychotic medications - Better Health Channel

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What are the common side effects of psychotropic drugs?
Side effects
 blurred vision.
 nausea.
 vomiting.
 trouble sleeping.
 anxiety.
 drowsiness.
 weight gain.
 sexual problems.
06-Nov-2019

What Is a Psychotropic Drug? Types, Uses, Side Effects, Risks ...

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What is the most troublesome side effect of antipsychotic medications?
These effects range from relatively minor tolerability issues (e.g., mild sedation or dry
mouth) to very unpleasant (e.g., constipation, akathisia, sexual dysfunction) to
painful (e.g., acute dystonias) to disfiguring (e.g., weight gain, tardive dyskinesia) to life‐
threatening (e.g., myocarditis, agranulocytosis).

Management of common adverse effects of antipsychotic medications

https://www.ncbi.nlm.nih.gov › articles › PMC6127750

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What are the long term effects of psychiatric medication?
And long-term use has been proven to create a lifetime of physical and mental
damage, a fact ignored by psychiatrists. Common and well-documented side effects of
psychiatric drugs include mania, psychosis, hallucinations, depersonalization, suicidal
ideation, heart attack, stroke and sudden death.

Psychiatric Drugs—Side Effects

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Can psychiatric medicine cause brain damage?
We know that antipsychotics shrink the brain in a dose-dependent manner (4)
and benzodiazepines, antidepressants and ADHD drugs also seem to cause
permanent brain damage (5).09-Sept-2014

Psychiatric drugs cause permanent brain damage | The BMJ

https://www.bmj.com › content › bmj.g5312

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What is the possible long term side effect of antipsychotic medication?
Many antipsychotics increase risk for metabolic syndrome and thus the risk of
heart disease, diabetes, and stroke (7), which are among the common causes of
premature mortality in schizophrenia (8).05-May-2017

The Long-Term Effects of Antipsychotic Medication on ...

https://ajp.psychiatryonline.org › appi.ajp.2017.16091016

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Do antipsychotics destroy the brain?
Scientific article: Neuroleptic (antipsychotic) drugs may cause cell death. This medical
research revealed that the neuroleptics (also known as antipsychotics) may not only
shrink the brain, but cause actual cell death.15-Sept-2007

Brain Damage Caused by Neuroleptic Psychiatric Drugs — MFIPortal

https://mindfreedom.org › neuroleptic-brain-damage

Search for: Do antipsychotics destroy the brain?

What is the most common neurological side effect of antipsychotic medication?
Sedation (sleepiness)

Sedation, or sleepiness, is a common side effect of many antipsychotics.

What side effects can antipsychotics cause? - Mind

https://www.mind.org.uk › drugs-and-treatments › side-ef...

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medication?
What are the 7 classifications of psychotropic medications?
Types of Psychotropic Medications. There are five main types of psychotropic
medications: antidepressants, anti-anxiety medications, stimulants, antipsychotics, and
mood stabilizers. Antidepressants are used to treat depression. 20-Apr-2021

Psychotropic Medications: Types, Their Use, and Side Effects -

WebMD
https://www.webmd.com › mental-health › what-are-psyc...

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How do you manage side effects of psychotropic medications?
What are the 5 classes of psychotropic medication?
According to the ATC classification, psychotropic drugs are generally considered to
belong only to one of five classes: antipsychotics, antidepressants, anxiolytics,
hypnotics, and mood stabilizers. However, these classes fail to account for different
recently approved psychotropic agents.

A new nomenclature for classifying psychotropic drugs - PMC - NCBI

https://www.ncbi.nlm.nih.gov › articles › PMC5510058

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What is the safest antipsychotic medication?
Does your brain go back to normal after antipsychotics?
Which antipsychotic has least side effects?
Is psychiatric medicines harmful?
Because psychotropic drugs are immensely harmful when used long term, they
should almost exclusively be used in acute situations and always with a firm plan for
tapering off, which can be difficult for many patients. 12-May-2015

Does long term use of psychiatric drugs cause more harm than good?
https://www.ncbi.nlm.nih.gov › articles › PMC4707562

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Do psychiatric medications cause more harm than good?
Psychiatric drugs do more harm than good and the use of most antidepressants and
dementia drugs could be virtually stopped without causing harm, an expert on clinical
trials argues in a leading medical journal.12-May-2015
Psychiatric drugs do more harm than good, says expert - The
Guardian
https://www.theguardian.com › society › may › psychiatri...

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What happens when you stop taking psychiatric medication?
Do psychiatric drugs shorten lifespan?
Antipsychotics and awareness

This is important, because side-effects of medicines used to treat severe mental

illness – such as schizophrenia – are a contributory factor in lower life
expectancy.02-Mar-2020

Antipsychotics can be life-changing, but they can also put patients at

risk
https://theconversation.com › antipsychotics-can-be-life-c...

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How do you treat mental illness without medication?
Things like therapy, brain stimulation, supplements, and self-care are scientifically-
backed as effective ways to reduce the symptoms of certain mental illnesses.

Non-Medication Treatments for Mental Health

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Does your brain go back to normal after antidepressants?
"The fact that antidepressant withdrawal can be so prolonged suggests that the drug
has changed the brain and that those changes are taking a very long time to return to
normal and it may be the case that sometimes they don't go back to normal."09-Apr-
2019

Long-term use of antidepressants could cause permanent damage ...

https://news.sky.com › story › long-term-use-of-antidepre...

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How long should you be on antipsychotics?
When do you stop taking antipsychotics?
Do antipsychotics cause permanent brain changes?

Meyer-Lindberg himself published a study last year showing that antipsychotics cause

quickly reversible changes in brain volume that do not reflect permanent loss of
neurons (see 'Antipsychotic deflates the brain')7.07-Feb-2011

Antipsychotic drugs could shrink patients' brains - Nature

https://www.nature.com › articles › news.2011.75

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Can you ever get off antipsychotics?
Are antipsychotics for life?
Do antipsychotics affect intelligence?
Patients on non-standard antipsychotic medication demonstrated poorer
performance than those on standard medication on visual memory, delayed
recall, performance IQ, and executive function.21-Jun-2006

Antipsychotic medication and cognitive function in schizophrenia

https://pubmed.ncbi.nlm.nih.gov › ...
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What medications cause neurological problems?
Which adverse effect is most likely to be experienced by older adults taking psychiatric
medication?
What is the primary reason that patients stop taking antipsychotic medications?
What are the most widely prescribed psychiatric drugs?
What are good mood stabilizers?
What pills do u take for anxiety?
Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of
medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam),
Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief
within 30 minutes to an hour.

Anxiety Medication - HelpGuide.org

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What are the top 3 antidepressants?
What are the strongest antidepressants?
What is the most tolerated antidepressant?
What will antipsychotics do to a normal person?
Side-effects of typical antipsychotics vary depending on the drug and may include
drowsiness, agitation, dry mouth, constipation, blurred vision, emotional blunting,
dizziness, stuffy nose, weight gain, breast tenderness, liquid discharge from breasts,
missed periods, muscle stiffness or spasms.

Antipsychotic Medication - CAMH

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Do antipsychotics change your face?
Do antipsychotics change personality?
Do psychiatric drugs side effects?
Do psychiatric drugs make tired?
Can psychiatric medicine cause brain damage?
How do psychiatric drugs affect the brain?
Can psychiatric drugs make you worse?
Which mental illness is the most severe?
Can psychiatric medications cause memory loss?
How long can you live with mental illness?
What vitamins help mental health?
What vitamin is a natural antidepressant?
Can you ever recover from mental illness?
How long antidepressants should be taken?
What happens if a normal person takes antidepressants?
What are the long term effects of antidepressants?
Which is the safest antipsychotic?
Do antipsychotics destroy the brain?
What are the long term effects of antipsychotics?
Does brain go back to normal after antipsychotics?
What are the risks of taking antipsychotics?
Do psychiatric medications cause more harm than good?
How do you treat mental illness without medication?
Do antipsychotics do more harm than good?
What is the first drug of choice for anxiety?
What is the strongest anti anxiety pill?
Is anxiety a mental illness?
Feedback

What happens if a normal person takes antidepressants?

There is new reason to be cautious about using popular antidepressants in people who
are not really depressed. For the first time, research has shown that a widely used
antidepressant may cause subtle changes in brain structure and function when
taken by those who are not depressed.

What antidepressants can do to a brain that is not depressed

https://med.unsw.edu.au › news-events › news › what-anti...

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What are the long term effects of antidepressants?

Long-Term Effects of Antidepressants

 Sexual problems (72%), including the inability to reach orgasm (65%)
 Weight gain (65%)
 Feeling emotionally numb (65%)
 Not feeling like themselves (54%)
 Reduced positive feelings (46%)
 Feeling as if they're addicted (43%)
 Caring less about other people (36%)
 Feeling suicidal (36%)
19-Feb-2021

Long-Term Effects of Antidepressants - Verywell Mind

https://www.verywellmind.com › long-term-effects-of-ant...

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Which is the safest antipsychotic?
Do antipsychotics destroy the brain?
Scientific article: Neuroleptic (antipsychotic) drugs may cause cell death. This medical
research revealed that the neuroleptics (also known as antipsychotics) may not only
shrink the brain, but cause actual cell death.15-Sept-2007
Brain Damage Caused by Neuroleptic Psychiatric Drugs — MFIPortal
https://mindfreedom.org › neuroleptic-brain-damage

Search for: Do antipsychotics destroy the brain?

What are the long term effects of antipsychotics?
Does brain go back to normal after antipsychotics?
For neurological, neuropsychological, neurophysiological, and metabolic abnormalities
of cerebral function, in fact, there is evidence suggesting that antipsychotic
medications decrease the abnormalities and return the brain to more normal
function.23-Jan-2019

Brain changes in people never medicated for mental illness and ...
https://mentalillnesspolicy.org › myths › medications

Search for: Does brain go back to normal after antipsychotics?

What are the risks of taking antipsychotics?
Possible side-effects of antipsychotics include:
 dry mouth.
 dizziness.
 weight gain that can lead to diabetes.
 blurred vision.
 movement effects (for example, tremor, stiffness, agitation)
 sedation (for example causing sleepiness or low energy)
 loss of menstrual periods in women.
 fluid retention.
More items.

Psychotropic Medication Side Effects

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PDF
All medications have side effects. Side effects can be harmful or not depending on
the medication, dose and characteristics of individual such as overall health ...
https://www.mind.org.uk/information-support/drugs-and-treatments/antipsychotics/side-effects/

https://www.cchr.org/quick-facts/psychiatric-drugs-side-effects.html

https://www.bmj.com/content/349/bmj.g5312/rr/775731

Rapid Response:

Yaffe, Boustani and Fairbanks (1) commented on a carefully conducted study that showed that
exposure to benzodiazepines doubled the risk of developing Alzheimer’s disease. They found it
likely that use of benzodiazepines lead to permanent brain damage, which they called
neurodegenerative disease. My preference is to call a spade for a spade, which is more easily
understood by the patients. It is less clear that we talk about a drug induced harm if we call it a
“disease”.

Yaffe, Boustani and Fairbanks also say - without any references - that depression and anxiety are
considered risk factors for Alzheimer’s disease. However, the studies psychiatrists usually refer
to when they make such claims do not hold water. A prominent Danish depression researcher
recently mentioned in an article, that antidepressant treatment might possibly reduce the doubled
risk of dementia in people who have previously had depression (2). He referred to a meta-
analysis (3), which is quite typical for the research in this area. It didn’t say anything about
earlier treatment and there wasn’t the least consideration that the increased risk could be caused
by the antidepressant drugs the patients had received.

We know that antipsychotics shrink the brain in a dose-dependent manner (4) and
benzodiazepines, antidepressants and ADHD drugs also seem to cause permanent brain damage
(5). Leading psychiatrists and the drug industry usually say that it is the disease that destroys
people’s brain, but it is very likely the drugs that do it, which also animal studies have found.
This is an important reason why I advocate that we should use psychiatric drugs very little, and
mostly in the acute phase, if people are seriously disturbed.

1. Yaffe K, Boustani M, Fairbanks RM. Benzodiazepines and risk of Alzheimer’s disease. BMJ
2014;349:g5312.

2. Videbech P. Debatten om antidepressiv medicin - Virker det, og bliver man afhængig?

BestPractice Psykiatri/Neurologi 2014;maj:nr 25.

3. Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for
Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen
Psychiatry 2006;63:530-8.

4. Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment

and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry
2011;68:128-37.
5. Whitaker R. Anatomy of an Epidemic. New York: Broadway Paperbacks; 2010.

Competing interests: No competing interests

06 October 2014

Benzodiazepines and risk of Alzheimer’s disease

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5312 (Published 09 September 2014)Cite this
as: BMJ 2014;349:g5312

 Article
 Related content
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 Responses
1. Kristine Yaffe, Roy and Marie Scola endowed chair and professor of psychiatry12,  
2. Malaz Boustani, Richard M Fairbanks professor in aging research34
Author affiliations
1. Correspondence to: K Yaffe, 4150 Clement St, Box 181G, San Francisco, CA 94121,
USA [email protected]

Prescribers and patients need a proper surveillance system for cognitive side
effects
A growing number of observational studies have shown the critical role of potentially
inappropriate medications for increasing the risk of cognitive impairment. In a linked paper,
Billioti de Gage and colleagues (doi:10.1136/bmj.g5205) extend the pharmacoepidemiological
research on the adverse cognitive effects of benzodiazepines with an investigation of their link
with Alzheimer’s disease.1 Their results suggest that long term exposure to benzodiazepines
might be a modifiable risk factor for this condition.
The authors conducted a nested case-control study of about 2000 older members of a public drug
plan in the province of Quebec, Canada. They observed a cumulative dose-effect association
between exposure to benzodiazepines (at least 90 days) and risk of developing Alzheimer’s
disease and found that exposure lasting more than 180 days was associated with a nearly twofold
increase in risk. In further analyses, they showed that longer acting benzodiazepines were
associated with greater risk of developing Alzheimer’s disease compared with shorter acting
benzodiazepines, adding support for a causal association.

The interpretation of these findings is …

View Full Text

Benzodiazepines and risk of Alzheimer’s disease

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5312 (Published 09 September 2014)Cite this
as: BMJ 2014;349:g5312

 Article
 Related content
 Metrics
 Responses

Related articles
 Research
Benzodiazepine use and risk of Alzheimer’s disease: case-control study
Published: 09 September 2014; BMJ 349 doi:10.1136/bmj.g5205

ResearchBenzodiazepine use and risk of Alzheimer’s disease: case-control study

https://www.healthline.com/health/what-is-a-psychotropic-drug#major-classes

What Is a Psychotropic
Drug?
 Fast facts

 Uses

 Drug table

 Major classes

 Risks

 Drug interactions

 Legal issues

 Emergency

 Bottom line
A psychotropic describes any drug that affects behavior, mood, thoughts, or
perception. It’s an umbrella term for a lot of different drugs, including
prescription drugs and commonly misused drugs.
We’ll focus on prescription psychotropics and their uses here.

The Substance Abuse and Mental Health Services Administration

(SAMHSA) National Survey on Drug Use and Health data found that in 2018,
47 million adults over age 18 reported a mental health condition.

This is around 1 in 5 adults in the United States. More than 11 million reported
serious mental illness.

Mental health and well-being affect our daily lives. Psychotropic medications
can be an important part of the tools available to help keep us well.

Fast facts about psychotropic

drugs
 Psychotropics are a broad category of drugs that treat many different
conditions.
 They work by adjusting levels of brain chemicals, or neurotransmitters,
like dopamine, gamma aminobutyric acid (GABA), norepinephrine, and
serotonin.
 There are five major classes of legal psychotropic medications:
o anti-anxiety agents
o antidepressants
o antipsychotics
o mood stabilizers
o stimulants
 Some can cause very serious side effects and have special monitoring
requirements by healthcare providers.
Why are psychotropic drugs
prescribed?
Some conditions psychotropics treat include:

 anxiety
 depression
 schizophrenia
 bipolar disorder
 sleep disorders

These medications work by altering neurotransmitters to improve symptoms.

Each class works a bit differently, but they have some similarities, too.

The type or class of medication a doctor prescribes depends on the individual

and specific symptoms. Some medications require regular use for several
weeks to see benefits.

Let’s look closer at psychotropic drugs and their uses.

Classes and names of

psychotropic drugs
Class Examples

Typical antipsychotics chlorpromazine (Thorazine);

fluphenazine (Prolixin);
haloperidol (Haldol);
perphenazine (Trilafon);
thioridazine (Mellaril)

aripiprazole (Abilify);
clozapine (Clozaril);
iloperidone (Fanapt);
olanzapine (Zyprexa);
Atypical antipsychotics
paliperidone (Invega);
quetiapine (Seroquel);
risperidone (Risperdal);
ziprasidone (Geodon)

alprazolam (Xanax);
clonazepam (Klonopin);
Anti-anxiety agents
diazepam (Valium);
lorazepam (Ativan)

amphetamine (Adderall, Adderall XR);

dexmethylphenidate (Focalin, Focalin XR);
dextroamphetamine (Dexedrine);
Stimulants
lisdexamfetamine (Vyvanse);
methylphenidate (Ritalin, Metadate ER,
Methylin, Concerta)

citalopram (Celexa);
Selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro);
antidepressants fluvoxamine (Luvox);
paroxetine (Paxil); sertraline (Zoloft)

atomoxetine (Strattera);
Serotonin-norepinephrine reuptake inhibitor (SNRI) duloxetine (Cymbalta);
antidepressants venlafaxine (Effexor XR); desvenlafaxine
(Pristiq)

isocarboxazid (Marplan);
phenelzine (Nardil);
Monoamine oxidase inhibitor (MAOI)
tranylcypromine (Parnate);
antidepressants
selegiline (Emsam, Atapryl, Carbex, Eldepryl,
Zelapar)
amitriptyline;
amoxapine;
desipramine (Norpramin); imipramine
Tricyclic antidepressants
(Tofranil);
nortriptyline (Pamelor); protriptyline (Vivactil)

carbamazepine (Carbatrol, Tegretol, Tegretol

XR);
Mood stabilizers divalproex sodium (Depakote);
lamotrigine (Lamictal);
lithium (Eskalith, Eskalith CR, Lithobid)

Major classes of psychotropic

drugs, their uses, and side effects
We’ll briefly cover the classes and some of the symptoms psychotropics treat.

Always talk to your doctor about the specific symptoms you’re experiencing.
They’ll find the best treatment options available to help you feel better.

This includes nonmedication options, such as cognitive behavioral therapy.

Some medications, such as antipsychotic medications, may take up to 2

weeksTrusted Source to help with symptom relief. It’s important to give the
medicine a chance to work before stopping it.

Anti-anxiety agents

Anti-anxiety agents, or anxiolytics, can treat different types of anxiety disorder,

including social phobia related to public speaking. They can also treat:
 sleep disorders
 panic attacks
 stress

How they work

This class is known as benzodiazepines (BZD)Trusted Source. They’re

recommended for short-term use. BZDs work by increasing GABA levels in
the brain, which causes a relaxing or calming effect. They have serious side
effects, including dependence and withdrawal.

Side effects

Side effects of BZDs include:

 dizziness
 drowsiness
 confusion
 loss of balance
 memory problems
 low blood pressure
 slow breathing

Caution

These medications may be habit-forming if used long term. They’re not

recommended for more than a few weeks.

SSRI antidepressants
SSRIs are mainly used to treat different types of depression. Among them are
major depressive disorder and bipolar disorder.

Depression is more than feeling sad for a few days. It’s persistent symptoms
that last for weeks at time. You may also have physical symptoms, like sleep
issues, lack of appetite, and body aches.

How they work

SSRIs work by increasing the amount of serotonin available in the brain.

SSRIs are the first choice of treatment for many types of depression.

Side effects

Side effects of SSRIs include:

 dry mouth
 nausea
 vomiting
 diarrhea
 poor sleep
 weight gain
 sexual disorders

Caution

Some SSRIs can cause elevated heart rate. Some can increase your risk for
bleeding if you’re also using blood thinning medications, such as nonsteroidal
anti-inflammatory drugs like aspirin or warfarin (Coumadin, Jantoven).

SNRI antidepressants
How they work

SNRIs help treat depression but work a bit differently than SSRIs. They
increase both dopamine and norepinephrine in the brain to improve
symptoms. SNRIs might work better in some people if SSRIs haven’t brought
improvement.

Side effects

Side effects of SNRIs include:

 headache
 dizziness
 dry mouth
 nausea
 agitation
 sleep problems
 appetite issues

Caution

These drugs can increase blood pressure and heart rate. Your liver function
must be monitored while on these medications as well.

MAOI antidepressants

These drugs are older and aren’t used very often today.
How they work

MAOIs improve symptoms of depression by increasing dopamine,

norepinephrine, and serotonin levels in the brain.

Side effects

Side effects of MAOIs include:

 nausea
 vomiting
 dizziness
 diarrhea
 dry mouth
 weight gain

Caution

MAOIs taken with certain foods that have the chemical tyramine can increase
blood pressure to dangerous levels. Tyramine is found in many kinds of
cheese, pickles, and some wines.

Tricyclic antidepressants

These are one of the oldest classes of antidepressants still available on the
market. They’re reserved for use when newer medications haven’t been
effective.
How they work

Tricyclics increase the amount of serotonin and norepinephrine in the brain to

improve mood.

Doctors also use tricyclics off-label to treat other conditions. Off-label use
means a drug is used for a condition that doesn’t have Food and Drug
Administration (FDA) approval for that condition.

Off-label uses for tricyclics include:

 panic disorder
 migraine
 chronic pain
 obsessive-compulsive disorder

Side effects

Side effects include:

 dry mouth
 dizziness
 drowsiness
 nausea
 weight gain

Caution

Certain groups should avoid tricyclics. This includes people with:

 glaucoma
 enlarged prostate
 thyroid issues
 heart problems

These medications can raise blood sugar. If you have diabetes, you may have
to carefully monitor your sugar levels.

Typical antipsychotics

These drugs treat symptoms associated with schizophrenia. They may also
be used for other conditions.

How they work

Typical antipsychotics block dopamine in the brain. The first antipsychotic

drug in this class, chlorpromazine, was introduced more than 60 years
agoTrusted Source. It’s still in use today.

Side effects

Side effects of antipsychotic drugs include:

 blurred vision
 nausea
 vomiting
 trouble sleeping
 anxiety
 drowsiness
 weight gain
 sexual problems
Caution

This class of drugs causes movement-related disorders

called extrapyramidal side effects. These can be serious and long lasting.
They include:

 tremors
 uncontrolled facial movements
 muscle stiffness
 problems moving or walking

Atypical antipsychotics

These are the next generationTrusted Source of medications used to treat

schizophrenia.

How they work

These drugs work by blocking brain chemicals dopamine D2 and serotonin 5-

HT2A receptor activity.

Doctors also use atypical antipsychotics to treat symptoms of:

 bipolar disorder
 depression
 Tourette syndrome

Side effects

Atypical antipsychotics have some serious side effectsTrusted Source. These

include an increased risk of:
 diabetes
 high cholesterol levels
 heart muscle–related problems
 involuntary movements, including muscle spasms, tremors
 stroke

Side effects of atypical antipsychotics include:

 dizziness
 constipation
 dry mouth
 blurred vision
 weight gain
 sleepiness

Caution

Aripiprazole (Abilify), clozapine (Clozaril), and quetiapine (Seroquel) have a

black box warning for specific safety concerns. There’s a risk of suicidal
thoughts and behaviors in people under the age of 18 who take one of these
medications.

Mood stabilizers

Doctors use these drugs to treat depression and other mood disorders, like
bipolar disorder.
How they work

The exact way mood stabilizers work isn’t well understood yet. Some
researchers believe these medications calm specific areas of the brain that
contribute to the mood changes of bipolar disorder and related conditions.

Side effects

Side effects of mood stabilizers include:

 dizziness
 nausea
 vomiting
 tiredness
 stomach problems

Caution

The kidneys remove lithium from the body, so kidney function and levels of
lithium must be regularly checked. If you have poor kidney function, your
doctor may need to adjust your dose.

Stimulants

These drugs mainly treat attention deficit hyperactivity disorder (ADHD).

How they work

Stimulants increase dopamine and norepinephrine in the brain. The body can
develop dependence if used long term.
Side effects

Side effects of stimulants include:

 problems with sleep

 poor appetite
 weight loss

Caution

Stimulants can increase heart rate and blood pressure. They may not be the
best option if you have heart or blood pressure problems.

Risks and black box warnings for

psychotropics
The FDA requires boxed warningsTrusted Source for certain medications or
classes of medications. These can be for three main reasons:

1. The risk of a dangerous adverse reaction must be weighed over its

benefits before use.
2. A dose adjustment might be needed for safe prescribing.
3. A specific group of people, such as children or pregnant women, might
need special monitoring for safe use.

Here are a few drugs and classes with boxed warnings. This isn’t a full list of
warnings. Always ask your doctor or pharmacist about specific drug side
effects and risks:
 Aripiprazole (Abilify) and quetiapine (Seroquel) aren’t FDA approved for
use in anyone under age 18 due to the of risk suicidal thoughts and
behavior.
 Antipsychotic medication use in older adults with dementia-related
psychosis can increase the risk of death.
 Antidepressants can worsen suicidal thoughts and behavior in children
and adolescents.
 Stimulant drugs may cause dependence and addiction.
 Benzodiazepines taken with opioid medications can increase the risk of
overdose.
 Clozapine (Clozaril) can cause agranulocytosis, a serious blood
disorder. You need to have blood work done to monitor your white blood
cell count. It can also cause seizures as well as heart and breathing
problems, which can be life threatening.

Avoid mixing psychotropic drugs with alcohol. Some classes, like BZDs,
antidepressants, and antipsychotic medications, have greater sedating effects
with alcohol. This can create problems with balance, awareness, and
coordination. It can also slow or stop breathing, which may be life threatening.

Drug interactions
Psychotropic drugs have many interactions with other drugs, food, alcohol,
and over-the-counter (OTC) products. Always tell your doctor and pharmacist
all the medications and supplements you’re taking to avoid adverse reactions.

Stimulant drugs like amphetamine interact with:

 SSRIs
 SNRIs
 MAOIs
 tricyclics
 lithium

Combining these drugs can cause a serious reaction called serotonin

syndrome. If you need to take both types of medications, your doctor will
modify the doses to avoid adverse interactions.

SPECIAL WARNINGS FOR CHILDREN, PREGNANT ADULTS, AND

OLDER ADULTS

 Children. Some psychotropic drugs have a higher risk of side effects in

children and aren’t FDA approved for use in children. Your doctor will
discuss risks versus benefits of specific medications.
 Pregnancy. There’s limited information on the use of psychotropics
during pregnancy. The benefits and risks must be carefully considered
for each person and each drug. Certain drugs, such as BZDs and
lithium, are harmful during pregnancy. Some SSRIs can increase the
risk of birth defects. SNRI use in the 2nd trimester can cause withdrawal
symptoms in babies. Your doctor must carefully monitor you and your
baby if you’re using any psychotropics.
 Older adults. Certain drugs can take longer for your body to clear if
your liver or kidney aren’t working well. You may be taking more
medications, which can interact or increase the risk of side effects or
adverse reactions. Your dose might need an adjustment. Before starting
any new medications, be sure to discuss all your medications, including
OTC drugs and supplements, with your doctor.
Legal issues surrounding
psychotropic drugs
BZDs and stimulants are controlled substances because they can cause
dependence and have the potential for misuse.

Never share or sell your prescription medications. There are federal penalties
for selling or illegally buying these medications.

These medications can also cause dependence and lead to substance use
disorders.

If you or a loved one is at risk for self-harm, reach out to the National Suicide
Prevention Lifeline at 800-273-TALK for help.

For support and to learn more about substance use disorders, reach out to
these organizations:

 Narcotics Anonymous (NA)

 National Institute on Drug Abuse (NIDA)Trusted Source
 Substance Abuse and Mental Health Services Administration
(SAMHSA)

When to seek emergency care

Psychotropic medications can have serious side effects. In some people, side
effects can be severe.

SEEK EMERGENCY TREATMENT

Call your doctor or 911 right away if you have any of these symptoms:

 your symptoms are getting worse (depression, anxiety, mania)

 thoughts of suicide
 panic attacks
 agitation
 restlessness
 insomnia
 increased heart rate and blood pressure
 feeling irritable, angry, violent
 acting impulsively and any other dramatic changes in behavior
 seizures

The bottom line

Psychotropics cover a very large category of drugs that are used to treat
many different types of symptoms.

They all work by adjusting neurotransmitter levels to help you feel better.

The medication your doctor prescribes depends on many factors, like your
age, other health conditions you may have, other medications you’re using,
and your past medication history.

Not all medications work right away. Some take time. Be patient, and talk to
your doctor if your symptoms are getting worse.

Discuss all treatment options, including cognitive behavioral therapy, with your
healthcare provider to develop the best care plan for you.
Last medically reviewed on November 6, 2019

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FEEDBACK:

Medically reviewed by Alan Carter, Pharm.D. — Written by Malini Ghoshal,

RPh, MS on November 6, 2019
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HealthlineMedical News TodayGreatistPsych Central

https://www.healthline.com/health/what-is-a-psychotropic-drug#legal-issues

https://www.webmd.com/mental-health/what-are-psychotropic-medications

What Are Psychotropic Medications?

By WebMD Editorial Contributors

 Medically Reviewed by Dan Brennan, MD on April 20,

2021

IN THIS ARTICLE
 How Psychotropic Medications Work
 Types of Psychotropic Medications
 Minimizing Complications
Psychotropic medications are used to treat mental health
disorders. There are five main types of psychotropic
medications, and each type has its own specific uses,
benefits, and side effects. Your doctor can help you decide
which psychotropic medication is right for you. 
How Psychotropic Medications Work

Many psychotropic medications work by adjusting the

number of major chemicals in the brain. These chemicals
are called neurotransmitters. Increasing or decreasing
certain neurotransmitters can counter the effects of
certain mental health disorders. 
Neurotransmitters. Neurotransmitters are the
messengers that allow your brain cells to communicate
with one another. If you have weak or overactive
neurotransmitters, they can produce unnecessary chemical
reactions that lead to a mental health condition. 
Psychotropic medications are not a cure. They can
only treat mental health disorders, and they are
sometimes most effective when combined with
psychotherapy. 
Types of Psychotropic Medications

There are five main types of psychotropic medications:

antidepressants, anti-anxiety medications, stimulants,
antipsychotics, and mood stabilizers.
Antidepressants are used to treat depression. There
are many different types of antidepressants. Some types
are less frequently used than others but may work for you
in consultation with your doctor. The most common
antidepressants are:

 Selective serotonin reuptake inhibitors (SSRIs), which

steadily increase the amount of serotonin in your
brain. Serotonin is a powerful neurotransmitter that
regulates your mood, bowel movements, sleep, blood
clotting, and more. 
 Selective norepinephrine reuptake inhibitors (SNRIs),
which gradually increase the amount of
norepinephrine in your brain. Norepinephrine makes
you feel awake and alert.
 Bupropion, which promotes important brain activity
and can be used to treat seasonal affective disorder
(SAD) or to help people quit smoking. 

Side effects of antidepressants include:

 Drowsiness
 Insomnia
 Constipation
 Weight gain
 Sexual problems
 Tremors
 Dry mouth ‌

Anti-anxiety medications treat an array of anxiety

disorders. These medications can be used to treat panic
attacks, phobias, generalized anxiety, and various anxiety-
related symptoms. 
Anti-anxiety medications include beta-blockers that help
treat the physical symptoms of anxiety, including
increased heartbeat, nausea, sweating, and trembling.
Because they typically cause drowsiness, some
tranquilizers and sleep medications are also used to treat
anxiety and insomnia. These tend to be prescribed for only
a short time to prevent dependency. 

SUGGESTED



Potential side effects of anti-anxiety medications include:

 Nausea
 Blurry vision
 Headaches
 Confusion
 Fatigue
 Nightmares‌

Stimulants help manage unorganized behavior. They

accomplish this by improving concentration and having a
calming effect. Stimulants are often prescribed for people
with attention deficit hyperactivity disorder (ADHD). 
Some side effects of stimulants include:

 Insomnia
 Decreased appetite
 Weight loss ‌

Antipsychotics help manage psychosis. Psychosis

describes multiple conditions that affect the mind. They
are often indicated by the person becoming separated
from their reality and experiencing delusions or
hallucinations. 
Antipsychotics can help people with psychosis think more
clearly, feel calmer, sleep better, and communicate more
effectively. 
Antipsychotics can be used to treat:
 ADHD
 Depression
 Post-traumatic stress disorder (PTSD)
 Obsessive-compulsive disorder (OCD)
 Eating disorders 

Some side effects of antipsychotics include:

 Drowsiness
 Upset stomach
 Increased appetite
 Weight gain 

Mood stabilizers help regulate extreme

emotions. This doesn’t mean they don’t let you feel all
the good that life has to offer. They simply help you
manage your range of emotions. Mood stabilizers are
primarily used to treat bipolar disorder and extreme mood
swings. 
Some side effects of mood stabilizers include:

 Upset stomach
 Drowsiness
 Weight gain
 Dizziness
 Tremors
 Blurry vision
 Confusion 
Minimizing Complications

As with any medication, taking extra cautions with

psychotropic drugs can help prevent unnecessary
complications. 
 Avoid alcohol and illicit drugs when taking
psychotropic medications. Certain combinations can
be dangerous.
 Use caution when driving or operating machinery if
your medications cause fatigue or drowsiness.
 Women who are pregnant, breast-feeding, or may
become pregnant should talk to their doctor about
possible complications with their medications.
 Don’t suddenly stop taking your medications. This can
make you feel ill and cause severe side effects.
 If you experience adverse allergic reactions such as
fever, rashes, or similar side effects, contact your
doctor as soon as possible. 

Older adults. Older adults tend to take more medications

and have a higher risk of having negative drug
interactions, missing a dose, or overdosing. They also tend
to be more sensitive to medications, so proper dosage and
frequency are crucial to managing risks.
 Show Sources
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181628/

Psychiatric side effects of medications prescribed in internal

medicine
Rodrigo Casagrande Tango, MD*

Author information Copyright and License information Disclaimer

This article has been cited by other articles in PMC.

Go to:
Abstract

Several pharmacological treatments used in internal medicine can induce psychiatric side effects
(PSEs) that mimic diagnoses seen in psychiatry. PSEs may occur upon withdrawal or
intoxication, and also at usual therapeutic doses. Drugs that may lead to depressive, anxious, or
psychotic syndromes include corticosteroids, isotretinoin, levo-dopar mefloquine, interferon-a,
and anabolic steroids, as well as some over-the-counter medications. PSEs are often difficult to
diagnose and can be very harmful to patients. PSEs are discussed in this review, as well as
diagnostic clues to facilitate their identification.

Keywords: adverse effect, psychiatry, mechanism, risk
factor, diagnosis, mefloquine, chloroquine, metronidazole, isotretinoin, interferon, steroid, β-blocker

Psychiatric side effects (PSEs) can be Induced by the pharmacological treatment of physical
Illnesses. The clinical presentation of PSEs often resembles spontaneous psychiatric syndromes
(ie, noniatrogenic, naturally occurring diseases). PSEs can occur at usual doses, in cases of
intoxication, or during the days following withdrawal of a given treatment. PSEs range from
short-lasting anxiety to severe confusion, and alleged cases of suicide have even been reported.

The Diagnostic and Statistic Manual of Mental Disorders, Fourth Edition (DSM-IV)1 defines

some dozens of categories of PSE, according to the disorder and to the incriminated substance,
eg, “persisting dementia induced by sedatives, hypnotics or anxiolytics.” The DSM-IV categories
include drugs for therapeutic purposes, medication taken abusively, and other substances.
The International Classification of Diseases2 is very similar to DSM-W in its categorization, with
minor differences in terms of category codes.

The challenge of PSEs in everyday practice is the difficulty in recognizing these frequent and
potentially dangerous situations. The diagnosis of PSEs raises the same questions as the
diagnosis of any psychiatric sign or symptom, which means that the clinician has to consider a
rather long list of differential diagnoses.

The following concepts refer to PSEs, as well as to other kinds of side effects:

 Exposure: The period of time the patient received the drug suspected of inducing a side effect.
 Dechallenge: The interruption of the suspected medication, regardless of the remission of adverse
effects. Positive dechallenge means that remission was temporally associated with the interruption of
medication.
 Rechallenge: The reintroduction of the suspected drug. Positive rechallenge means that symptom
reappearance was temporally associated with suspected drug réintroduction.

A drug can be considered to have a high probability of causing side effects in cases of positive
exposure, with a positive dechallenge and a positive rechallenge.
The importance of PSEs relates to the potential harm of these side effects and to their high
incidence. Two examples are reserpine and corticosteroids. Reserpine, when it was prescribed,
may have caused mood disorders in 10% of treated subjects. With corticosteroids, 6% of all
patients develop some PSEs.3

The focus of this review is on depression, anxiety, and psychotic states, but a few other PSEs are
also mentioned. A summary of the PSEs is presented and some examples are given in detail. In
addition, diagnostic issues are discussed to facilitate identification of PSEs in internal medicine.
PSEs secondary to psychotropic medication (such as antidepressants, anxiolytics, antipsychotics,
or mood-stabilizing agents) are not described here. They probably induce more PSEs than the
compounds quoted here, since they act directly on the nervous system.

Go to:

Mechanisms of PSEs

As with any side effect, pharmacological mechanisms are divided according to their
pharmacokinetic or pharmacodynamic nature. Patient-specific factors also lead to PSEs.

Pharmacodynamic mechanisms

Medications used in the treatment of physical disorders can modify neurotransmitter systems (as
do psychotropic medications). These modes of action can imply a direct influence on
neurotransmitters, as is the case for dopaminergic agents in the treatment of Parkinson's disease.
Interleukin (IL) treatment is another example where there is a direct influence, since interleukins
are involved in neurotransmission as well as in many other bodily functions. Other
nonpsychotropic medications influence neurotransmitter systems in a more indirect manner, such
as corticosteroids or sex steroids.

It is interesting to compare the mode of action of nonpsychotropic medications with what is

known concerning the postulated pathophysiology of psychiatric disorders. Indeed, the
mechanisms of PSEs are sometimes compatible with a given hypothesis for the corresponding
spontaneous syndromes. For example, the occurrence of hallucinations and delusions on
dopamine agonists (eg, levodopa) is clearly within the domain of the dopaminergic hypothesis
for schizophrenia. In this case, there is a clear relationship between the hypothesis for a disease
and the postulated mechanisms of a side effect. In another example, that of depression as a side
effect of interferons (IFNs), the relationship is not so easily identifiable. Stress and depression
are associated with increased circulating concentrations of cytokines such as IL-1β, IL-6, γ-IFN,
and positive acute-phase proteins, and hyperactivity of the hypothalamus-pituitary-adrenal axis.
Immunological activation induces “stress-like” behavioral and neurochemical changes in
animals.4 An association of the cerebrospinal fluid (CSF) concentration of proinflammatory
cytokines and major depressive disorders was reported in depressed patients with higher CSF
concentrations of IL-lβ, lower IL-6, and no change in tumor necrosis factor a (TNF-α).5 A
positive correlation was found between serum IL-lp and the severity of depression. Other studies
suggest that antidepressants can act on neouroimmunomodulation, and have been shown to shift
the cytokines toward a decreased production of proinflammatory cytokines.6

Pharmacokinetic mechanisms

Pharmacokinetic mechanisms are relevant when the PSE is known to follow a dose-response
curve. A low clearance represents the main pharmacokinetic mechanism inducing PSEs, ie, other
changes in the pharmacokinetics of drugs are of little relevance. Disease states, hepatic enzyme
polymorphisms, and drug interactions leading to metabolic inhibition are the main reasons for a
low clearance.

Interaction by metabolic inhibition is a general principle, applicable not only to PSEs, but also to
other side effects. Many drugs inhibit one or more pathways of hepatic metabolism. Cytochrome
P-450 (CYP450) enzymes metabolize endogenous as well as a variety of exogenous substrates,
such as toxins and drugs. Some drugs are metabolized by one metabolic pathway, others by
many When all metabolic pathways of a medication are inhibited, then the concentration of this
drug will rise, favoring the occurrence of side effects.

Antifungals can inhibit some metabolic pathways, including those of mefloquine, ie, the 3 A4
isoenzyme of CYP450.7 Mefloquine can rarely lead to serious PSEs at prophylactic doses,8,9 but
these risks are greater at high plasma concentrations.10 The prescription of a macrolide antibiotic
will probably raise concentrations of mefloquine, as most macrolides are 3A4 inhibitors. Hence,
serious PSEs can occur even at usual doses of both drugs.

Go to:

Risk factors

Patient-specific mechanisms of PSEs are more precisely defined as patient-related risk factors.
The risk factors for developing PSEs can be medication-related or patientrelated, as shown
in Table 1

Table I.
Risk factors for psychiatric side effects (PSEs).

Medication-related PSEs

Polypharmacy
High doses

Route of administration (eg, intravenous or intrathecal)

Faster administration (by any route)

Narrow therapeutic index

Patient-related PSEs

Present or past mental illnesses

Hepatic insufficiency, slow metabolizer, and other metabolic conditions

Augmented permeability of the blood-brain barrier (eg, meningitis or porphyria)

Very young or elderly patients

Postpartum

Other situations of stress (eg, intensive care unit)

Open in a separate window

Polypharmacy is one of the most important iatrogenic risk factors for PSEs, because of the
addition of pharmacological effects or due to metabolic inhibition. Addition of pharmacological
effects is illustrated by the concomitant prescription of clozapine and biperiden. These drugs are
both potent anticholinergics, so the risk of anticholinergic side effects is greater when they are
taken together than with each medication taken alone. Polypharmacy mimics a slow metabolizer
picture for many drugs, when hepatic metabolism is inhibited. There are many inhibitors of
hepatic metabolism: omeprazole, cimetidine, antifungals, antivirals, HMG-CoA (3-hydroxy-3-
methylglutaryl coenzyme A) reductase inhibitors (statins), antihypertensives, antiepileptics,
antidepressants, grapefruit juice, and many other compounds. It is practically impossible to
memorize all the CYP450 isoenzyme substrates, inhibitors, and inducers. Hence pocket
tables11 and software12,13 are useful for obtaining rapid information about such drug-drug
interactions, and potentially avoiding induction of PSEs. Many PSEs are dose-dependent, so
their risk increases with factors that raise the concentration of drugs. The CYP450 2D6
isoenzyme has absent or impaired activity in 7% of Caucasians14,15 and the 2C19 activity is
absent or impaired in as many as 12% to 22% of Asians.15

Go to:
Diagnosis and differential diagnosis

The diagnosis of PSEs can be challenging. The clinical pre_ sentations of depressive, anxious, or
psychotic PSEs meet most criteria of the DSM-IV for the corresponding spontaneous
(noniatrogenic) syndromes. Therefore, almost any psychiatric symptom or syndrome could be
considered as a potential PSE, until one has proven the contrary.

A simple case would be that of a peculiar or unusual psychiatric symptom, observed in a person
who has started (or interrupted) a medical treatment recently and has no history of a previous
psychiatric decompensation and no evident susceptibility to develop such a decompensation. A
difficult case would be that of a person who has already suffered from many decompensations of
psychiatric disorders and who develops a recurrence that presents itself clinically in a similar
manner as that known for the subject. In this case, a PSE can easily be overlooked, ie, the role of
a medical treatment as a relevant factor is difficult to identify Another case is that of a physical
disorder that can also induce psychiatric signs. For example, the clinician might not be able to
determine whether a case of depression relates to the patient's multiple sclerosis or to the
corticosteroid treatment. Another example would be a malaria patient treated with mefloquine
and presenting delirium: is the delirium due to the malaria rather than to the mefloquine?

The fact of being hospitalized for a severe physical illness constitutes a strain: in an intensive
care unit, the patient is exposed to pain, sleep deprivation, unusual environment, and threat of
disability or even death. In this context, it is difficult to distinguish reactive or drug-induced
psychological signs. Complex medical cases receive polypharmacy: some patients can receive
antiarrhythmics, bronchodilatators, analgesics, antibiotics, benzodiazepines, and other
medications. Among these complex situations, it can become practically impossible to determine
a single cause for a PSE. Yet, making such a diagnosis is necessary For example, in systemic
lupus erythematosus, the occurrence of PSEs can be due to corticosteroid treatment, but also to
the lupus cerebritis; the latter is associated with high levels of antibodies to P ribosomal proteins,
in both CSF and serum.16 This differential diagnosis is relevant, since the corticosteroid dose may
need to be increased.

The differential diagnoses of PSEs are summarized in Table II. History and chronology of drug
administration are first-line tools to diagnose a PSE. As already mentioned, an anamnesis with a
positive exposure, positive dechallenge, and positive rechallenge, indicates a high probability of
a causal link between a psychiatric sign and a prescribed medication.

Table II.
Differential diagnoses of psychiatric side effects (PSEs) of medications.

Dïagnoses other than medication side effects

Underlying physical illnesses with psychiatric symptoms (eg, multiple sclerosis, systemic neoplasias,
electrolytic disturbances, lupus erythematosus)

Aggravation of an existing psychiatric illness

Inaugural psychiatric decompensation in individuals with no evident susceptibility

Differential diagnoses among PSEs

PSEs at usual doses

Withdrawal-related PSEs. Side effects can occur after the discontinuation of antiparkinsonian agents,
benzodiazepines, antipsychotics, antidepressants, anabolic androgen steroids, etc

Intoxication-related PSEs

Open in a separate window

A PSE can differ from a spontaneous psychiatric syndrome in duration, since the duration of the
PSE is more linked to the presence or withdrawal of the offending agent. Once the incriminated
treatment is interrupted, behavioral symptoms usually remit within days to weeks, depending on
the half-life of the substance or the presence of a withdrawal syndrome. In complex cases of
polypharmacy, if the chronology of medication cannot help determine which medication caused
the side effect, a trial could be done by replacing one of the suspected drugs by another with a
lesser risk of PSEs.

Another issue about chronology concerns what can occur after interruption of treatment. This can
be illustrated by the case of an elderly male patient, who took St John's wort for 4 months, with
partial improvement of his depression. The dose was gradually increased, but without a complete
remission of the depression. Travel to an endemic zone of malaria was planned and mefloquine
prophylaxis was introduced. No side effect occurred during the first 10 days, until the clinician
decided to replace St John's wort by citalopram, without changes in the mefloquine prophylaxis.
The patient rapidly developed hallucinations after the introduction of citalopram. He had no
mental status changes when he received St John's wort and mefloquine, so the clinician stopped
citalopram. The hallucinations persisted. When mefloquine was discontinued, the hallucinations
remitted. The message is that even the interruption of a drug can lead to an increase in the
plasma concentrations of another drug, causing side effects. St John's wort Induces mefloquine
metabolism, which means that, In this case, mefloquine concentrations were lower while St
John's wort was given. Hallucinations are known side effects of mefloquine.

To improve the detection of PSEs, the physician should look for the anamnestic key factors listed
below:

 Dates of occurrence of psychiatric symptoms suspected of being side effects.

 Dates of medication exposure, dechallenge, and rechallenge.
 Previous psychiatric history.
 If polypharmacy is given, dates of Introduction or discontinuation of other drugs.
 Dates of factors worsening existing comorbidities.
 Plasma concentration measurements.

The most useful complementary examination for PSE Investigation Is generally the monitoring
of plasma concentratlons of suspected medications. Monitoring of drug concentration Is
frequently performed for some drugs with high risk of toxicity, eg, digoxin, theophylline, or
lidocaine. Many other compounds can also be dosed in specialized laboratories.

If past analyses were performed for a given patient, they may also provide valuable clues. This
may apply even if different medications were measured. This occurs because an abnormally high
concentration of a medication may suggest a weak or absent metabolic pathway, as discussed in
the mechanisms section above. Knowledge of the patient's deficiencies in metabolism allows
avoidance of some PSEs by future prescriptions. Genotyping is a complementary examination to
detect polymorphisms of hepatic enzymes.

Go to:

Description of psychiatric side effects

Table III 3,8,9,17-197 gives a list of medications that might induce depression, mania, anxiety, or
psychotic syndromes (defined by delusions and/or hallucinations). This information is
qualitative, in the sense that the severity or the frequency of these side effects under each
medication or class is not indicated. Specific information can be found in the bibliography. Some
psychotropics, such as benzodiazepines, are listed in Table III because they are frequently
prescribed in internal medicine. Obviously, more than one of these PSEs can occur in a given
patient. For example, many depressive states are accompanied by anxiety Some clinically
relevant examples of medications presented In Table III are discussed below in more detail.

Table III.
Psychiatric side effects potentially induced by pharmacological treatment.

Depressio
Mania Anxiety Psychotic symptoms
n

Amantadine17,22 X X X X

Aminoglycosides23,24 X
Depressio
Mania Anxiety Psychotic symptoms
n

Amphetamines25-30 X X X X

Anabolic steroids31-33 X X X X

Anesthetics21,22,34,35 X X

Anticholinergics21,36-39 X X X

Antihistamines21,22,40 X X

Antitubercular agents22,41-45 X X X

Antivirals46-53 X X X

Baclofen22,54-58 X X X X

Barbiturates22,59 X X X X

Benzodiazepines21,22,60-62 X X X

β-Blockers21,22,63-72 X X X X

Bromocriptine21,73-77 X X X

Cephalosporins22,78-80 X X

Chloroquine81-88 X X X X

Clonidine21,22,113-115 X X X X

Corticosteroids3,21,22,94-112 X X X X

Digoxin21,22,113-115 X X X

Disulfiram21,22,116-118 X X X X

Interferon-α22,119-131 X X X X
Depressio
Mania Anxiety Psychotic symptoms
n

Isotretinoin22,132-137 X X

Levodopa21,22,138-152 X X X X

Lidocaine153-157 X X X X

Mefloquine8,9,22,158-160 X X X X

Methyldopa21,22 X X X

Methylphenidate22,161-163 X X X

Metoclopramide21,22,164-169 X X X

Metronidazole22,170-175 X

Opioids21,22,176-181 X X X X

Oral contraceptives21,22,182,183 X X

X
Procainamide21,184-188

Emergencies caused by side effects of psychiatric medications

Author links open overlay panelMichael J.TuethMD

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https://doi.org/10.1016/0735-6757(94)90248-8Get rights and content

Abstract
Psychiatric medications cause side effects in several organ systems that need
emergency evaluation and treatment. Serious cardiovascular side effects include
postural hypotension, cardiac conduction blockade, and SA mode dysfunction; serious
neurological side effects include extrapyramidal reactions, seizures, delirium,
catatonia, pseudotumor cerebri, ataxia, and glaucoma; serious genitourinary side
effects include urinary retention, nephrotic syndrome, and priapism, and the serious
hematological side effect of agranulocytosis. Also potentially fatal syndromes
secondary to psychiatric drugs are the neuroleptic malignant syndrome,
hyperandrenergic crisis, the serotonin syndrome, and lithium toxicity. Individual
psychiatric drug classes most notorious for causing side effects with high morbidity
and mortality are low potency neuroleptics, clozapine, tertiary tricyclics, monoamine
oxidase inhibitors, and lithium.

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Keywords
Drugs

emergencies

medications

side effects

reactions

psychiatric

psychotropic
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Copyright © 1994 Published by Elsevier Inc.

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In public interest of psychiatric treatment imparted to psychiatric patients

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kaarthikeyan sudarsana babu <[email protected]>

to ma.subramaniandmk, mlakolathur, Minister, DMARANOFFICE, DMK, mkstalinoffice, hfsec, udhay

6.8.2022.

From
S.Karthikeyan,
110, old no.76, 2nd Street,
Kamaraj Avenue, Adyar,
Chennai-600020.
Cell:-9551011560.

To
Thiru.Ma.Subramanian,
Hon'ble Health Minister of Tamil Nadu,
Fort.St.George,
Secretariat, Chennai-600009.

Respected Minister Sir,

Sub:- In public interest of psychiatric treatment imparted to

psychiatric patients- reg.
The cause of psychiatric issues in persons is due to some
problems, set-backs, non-fullfillment of desires, some kind of
failures in their life,
either in career or personal life, which causes mental
depression, leading to ill-health physically and mentally,
abnormal behaviour.
So, I request psychological & hypnotherapy counselling,
tolerance, giving them needed affection to the
psychologically affected patients who are neglected and
harrassed, even abused, good healthy food as they
are mentally in the age of child's maturity. Actually, in
psychological counselling the cause of reasons, issues,
persons, some betrayal,harrassment by others,
 legal issues etc., as cause can be observed as the reasons for
a person to become psychiatric, there may be vested interest
to frame a person as psychiatric,
also there is spread of rumours against them for some reason
that's why without proper medical tests harmful treatment
related to brain psychiatric treatment by prescription of pills
is given,since victims mostly end up as psychiatric patients,
what is the motive and reason, benefit to frame a person as
psychiatric, whether there is medical test reports so?.

Also, psychiatric pills offer harmful side effects as I was

pointed out in early 2015 by my classmate/friend
Mr.Pugalendhi Dhanapalan,Correspondent
of Prof.Dhanapalan College in Kelambakkam next to
Chettinad Hospital, My friend Pugal told me to use Google
name with the psychiatric pills name by Google Search
engine which listed of side effects of psychiatric pills as
causing bi-polar disorder, since without test reports
Dr.Shanta Kamath, Additional Director of SCARF Foundation,
Chennai prescribed me psychiatric pills sold over SCARF
Counter for some reason without any tests hence my friend
Pugal advised me so, if so who is the beneficiary-the patient?
or the Doctor and the Foundation? or someone else??,
Respected Minister Sir.

For All human life, their well-being, mental capacity in a good

state of mind, their family welfare is most important for our
State of Tamil Nadu,that's why more immediate medical
attention by ambulance to accident victims, increased
highway patrol has been increased in this present DMK rule
of our Hon'ble CM. Our State of Tamil Nadu is dependent on
our Human Resource so providing the right treatment to
them is highly essential, Respected Minister Sir. Accident
treatment is physical, whereas psychiatric treatment is
related to the head and mind which is the key and main in the
central nervous system of the human body.

Enclosed files downloaded from the Internet are attached

below.
Prayers:-
Hence, based on my submissions, proper treatment for
psychiatric patients seeing their present poor health, brain
and nerves condition, physical condition
may be determined for the people's welfare, who become
psychiatric for some reason, the reason and cause for their
psychiatric condition has to be probed
by an expert in psychological & hypnotherapy counselling
before prescribing psychiatric pills is my submission and
humble request,Respected Minister Sir.

Thanking You, Respected Minister Sir,

Yours Sincerely,
S,Karthikeyan, Adyar, Chennai-20.
6.8.2022.
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