Skip to main content
×
×
Home

Adverse psychiatric effects of non-psychotropic medications

  • Ankit Gupta and Rakesh K. Chadda
Summary

Patients presenting to psychiatrists frequently have comorbid medical conditions for which they are receiving treatment. A range of medications used for treatment of these conditions can have adverse effects resembling psychiatric symptoms. This article presents the results of our review of the literature on psychiatric adverse effects of various non-psychotropic medications, and discusses the mechanisms of such effects, their assessment and management. Among the commonly prescribed drugs found to have psychiatric adverse effects are corticosteroids, anti-Parkinsonian drugs, anti-epileptics, antiretrovirals, antibiotics, anticancer drugs, analgesics, drugs targeting endocrine and cardiovascular disorders, immunosuppressants, skeletal muscle relaxants and bronchodilators. Some adverse effects are predictable and dose dependent, whereas others are rare and idiosyncratic, and psychiatrists need to be aware of them for accurate diagnosis and appropriate treatment.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Adverse psychiatric effects of non-psychotropic medications
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Adverse psychiatric effects of non-psychotropic medications
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Adverse psychiatric effects of non-psychotropic medications
      Available formats
      ×
Copyright
Corresponding author
Professor Rakesh K. Chadda, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India. E-mail: drrakeshchadda@gmail.com
Footnotes
Hide All

LEARNING OBJECTIVES

• Appreciate the existing evidence and methodological issues in studying adverse psychiatric effects of non-psychotropic drugs

• Improve knowledge about adverse psychiatric effects of commonly prescribed drugs for various medical disorders

• Develop a structured approach towards diagnosing and managing adverse psychiatric effects of non-psychotropic drugs

DECLARATION OF INTEREST

None

Footnotes
References
Hide All
Abers, MS, Shandera, WX, Kass, JS (2014) Neurological and psychiatric adverse effects of antiretroviral drugs. CNS Drugs, 28: 131–45.
Abramowicz, M (2008) Drugs that may cause psychiatric symptoms. Medical Letters on Drugs and Therapeutics, 50: 100–3.
Alomar, MJ (2014) Factors affecting the development of adverse drug reactions. Saudi Pharmaceutical Journal, 22: 83-94.
Bechstein, WO (2000) Neurotoxicity of calcineurin inhibitors: impact and clinical management. Transplant International, 13: 313–26.
Bersani, FS, Coviello, M, Imperatori, C et al (2015) Adverse psychiatric effects associated with herbal weight-loss products. BioMed Research International, 2015: 120679.
Borovaya, A, Olisova, O, Ruzicka, T et al (2013) Does isotretinoin therapy of acne cure or cause depression? International Journal of Dermatology, 52: 1040–52.
Celano, CM, Freudenreich, O, Fernandez-Robles, C et al (2011) Depressogenic effects of medications: a review. Dialogues in Clinical Neurosciences, 13: 103–25.
Cheslack-Postava, K, Keyes, KM, Lowe, SR et al (2015) Oral contraceptive use and psychiatric disorders in a nationally representative sample of women. Archives of Women's Mental Health, 18: 103–11.
Desai, AK (2004) Psychotropic side effects of commonly prescribed medications in the elderly. Primary Psychiatry, 11: 27-34.
Edwards, IR, Aronson, JK (2000) Adverse drug reactions: definitions, diagnosis, and management. Lancet, 356: 1255–9.
Ernst, E (2003) Serious psychiatric and neurological adverse effects of herbal medicines – a systematic review. Acta Psychiatrica Scandinavica, 108: 83-91.
Ernst, E (2007) Herbal remedies for depression and anxiety. Advances in Psychiatric Treatment, 13: 312–6.
Ferrando, SJ, Levenson, JL, Owen, JA (2010) Clinical Manual of Psychopharmacology in the Medically Ill. American Psychiatric Publishing.
Gordon, JL, Girdler, SS (2014) Hormone replacement therapy in the treatment of perimenopausal depression. Current Psychiatry Reports, 6: 517.
Heinrich, TW, Marcangelo, M (2009) Psychiatric issues in solid organ transplantation. Harvard Review of Psychiatry, 17: 398-406.
Holland, JC, Andersen, B, Breitbart, WS et al (2013) Distress management: clinical practice guidelines in oncology. Journal of National Comprehensive Cancer Network, 11: 190-209.
Holvey, C, Connolly, A, Taylor, D (2010) Psychiatric side effects of non-psychiatric drugs. British Journal of Hospital Medicine, 71: 432–6.
Hubbard, JR, Levenson, JL, Patrick, GA (1991) Psychiatric side effects associated with the ten most commonly dispensed prescription drugs: a review. Journal of Family Practice, 33: 177–86.
Huffman, JC, Stern, TA (2007) Neuropsychiatric consequences of cardiovascular medications. Dialogues in Clinical Neurosciences, 9: 29-45.
Janelsins, MC, Kohli, S, Mohile, SG et al (2011) An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Seminars in Oncology, 38: 431–8.
Judd, LL, Schettler, PJ, Brown, ES et al (2014) Adverse consequences of glucocorticoid medication: psychological, cognitive, and behavioral effects. American Journal of Psychiatry, 171: 1045–51.
Kenna, H, Poon, AW, De Los Angeles, CP et al (2011) Psychiatric complications of treatment with corticosteroids: review with case report. Psychiatry and Clinical Neurosciences, 65: 549–60.
Kersey, RD, Elliot, DL, Goldberg, L et al (2012) National athletic trainers' association position statement: anabolic-androgenic steroids. Journal of Athletic Training, 47: 567–88.
Keyes, KM, Cheslack-Postava, K, Westhoff, C et al (2013) Association of hormonal contraceptive use with reduced levels of depressive symptoms: a national study of sexually active women in the United States. American Journal of Epidemiology, 178: 1378–88.
Mehta, RD, Roth, AJ (2015) Psychiatric considerations in the oncology setting. CA: A Cancer Journal for Clinicians, 65: 299-314.
Meyer, RE, Salzman, C, Youngstrom, EA et al (2010) Suicidality and risk of suicide – definition, drug safety concerns, and a necessary target for drug development: a consensus statement. Journal of Clinical Psychiatry, 71: e1-21.
Myint, AM, Schwarz, MJ, Steinbusch, HW et al (2009) Neuropsychiatric disorders related to interferon and interleukins treatment. Metabolic Brain Disease, 24: 55-68.
Onder, G, Pellicciotti, F, Gambassi, G et al (2004) NSAID-related psychiatric adverse events: who is at risk? Drugs, 64: 2619–27.
Pachi, A, Bratis, D, Moussas, G et al (2013) Psychiatric morbidity and other factors affecting treatment adherence in pulmonary tuberculosis patients. Tuberculosis Research and Treatment, 2013: 1-37.
Parker, C (2012) Psychiatric effects of drugs for other disorders. Medicine, 40: 691–5.
Perucca, P, Gilliam, F (2012) Adverse effects of antiepileptic drugs. Lancet Neurology, 11: 792-802.
Raison, CL, Demetrashvili, M, Capuron, L et al (2005) Neuropsychiatric adverse effects of interferon-alpha: recognition and management. CNS Drugs, 19: 105–23.
Raja, M (2012) Impulsive and compulsive behaviors during dopamine replacement treatment in Parkinson's disease and other disorders. Current Drug Safety, 7: 63-75.
Rudorfer, MV, Hillefors, M (2012) Assessing psychiatric adverse effects during clinical drug development. Pharmaceutical Medicine, 26: 363–94.
Sidhu, KS, Balon, R (2008) Watch for nonpsychotropics causing psychiatric side effects. Current Psychiatry, 7(4): 61–4, 68–74.
Simons, FE, Simons, KJ (2008) H1 antihistamines: current status and future directions. World Allergy Organization Journal, 1: 145–55.
Suvada, J (2013) Neuropathic and neurocognitive complications of antiretroviral therapy among HIV-infected patients. Neuro Endocrinology Letters, 34 (suppl 1): 5-11.
Tango, RC (2003) Psychiatric side effects of medications prescribed in internal medicine. Dialogues in Clinical Neurosciences, 5: 155–65.
Turjanski, N, Lloyd, G (2005) Psychiatric side-effects of medications: recent developments. Advances in Psychiatric Treatment, 11: 58-70.
US Food and Drug Administration (2008) Information for Healthcare Profession als: Suicidal Behavior and Ideation and Antiepileptic Drugs (1/31/2008; Updated: 12/16/2008). FDA (http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100192.htm). Accessed 21 July 2016.
US Food and Drug Administration (2009) Safety Alerts for Human Medical Products: Antiepileptic Drugs. FDA (http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm074939.htm). Accessed 21 July 2016.
Warrington, TP, Bostwick, JM (2006) Psychiatric adverse effects of corticosteroids. Mayo Clinic Proceedings, 81: 1361–7.
Wefel, JS, Kesler, SR, Noll, KR et al (2015) Clinical characteristics, pathophysiology, and management of non-central nervous system cancer-related cognitive impairment in adults. CA: Cancer Journal for Clinicians 65: 123–38.
World Health Organization (2005) The Use of the WHO-UMC System for Standardised Case Causality Assessment. Uppsala Monitoring Centre (http://who-umc.org/Graphics/24734.pdf).
Zahodne, LB, Fernandez, HH (2008) Pathophysiology and treatment of psychosis in Parkinson's disease: a review. Drugs & Aging, 25: 665–82.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 5
Total number of PDF views: 120 *
Loading metrics...

Abstract views

Total abstract views: 381 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 23rd June 2018. This data will be updated every 24 hours.

Adverse psychiatric effects of non-psychotropic medications

  • Ankit Gupta and Rakesh K. Chadda
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *