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Toxic psychoses are psychotic states brought about by the build up of toxic substances in the brain. This may be associated with dietary factors, metabolic disorders or drug use
Metabolic disorders[]
- electrolyte disorders such as:
- hypoglycemia[9]
Psychoactive drug use and toxic psychoses[]
- Main article: Substance-induced psychosis
Psychotic states may occur after ingesting a variety of substances both legal and illegal and both prescription and non prescription. Drugs whose use, abuse or withdrawal are implicated include:
- alcohol[10][11][12]
- OTC drugs, such as:
- Dextromethorphan
- Certain antihistamines at high doses.[13][14][15][16]
- Cold Medications[17] (ie. containing Phenylpropanolamine, or PPA)
- prescription drugs:
- barbiturates[18][19]
- benzodiazepines[20][21][22]
- Isotretinoin
- Anticholinergic drugs
- antidepressants
- L-dopa
- antiepileptics[27]
- amphetamines[28]
- methamphetamine[28]
- methylphenidate[28]
- Illegal drugs, including:
Intoxication with drugs that have general depressant effects on the central nervous system (especially alcohol and barbiturates) tend not to cause psychosis during use, and can actually decrease or lessen the impact of symptoms in some people. However, withdrawal from barbiturates and alcohol can be particularly dangerous, leading to psychosis or delirium and other, potentially lethal, withdrawal effects.
Some studies indicate that cannabis use may lower the threshold for psychosis, and thus help to trigger full-blown psychosis in some people.[30] Early studies have been criticized for failing to consider other drugs (such as LSD) that the participants may have used before or during the study, as well as other factors such as pre-existing ("comorbid") mental illness. However, more recent studies with better controls have still found a small increase in risk for psychosis in cannabis users.[31]
It is not clear whether this is a causal link, and it is possible that cannabis use only increases the chance of psychosis in people already predisposed to it; or that people with developing psychosis use cannabis to provide temporary relief of their mental discomfort. The fact that cannabis use has increased over the past few decades, whereas the rate of psychosis has not, suggests that a direct causal link is unlikely for all users.[32]
It is also important to this topic to understand the paradoxical effects of some sedative drugs.[33].Serious complications can occur in conjunction with the use of sedatives creating the opposite effect as to that intended. Malcolm Lader at the Institute of Psychiatry in London estimates the incidence of these adverse reactions at about 5%, even in short-term use of the drugs.[34] The paradoxical reactions may consist of depression, with or without suicidal tendencies, phobias, aggressiveness, violent behavior and symptoms sometimes misdiagnosed as psychosis. [35][36]
See also[]
- Alcohol intoxication
- Alcoholic psychosis
- Organic brain syndromes
- Thyrotoxicosis
- Toxic encephalopathies
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- ↑ Rossman, Phillip L., Robert M. Vock (September 1956). Postpartum Tetany and Psychosis Due to Hypocalcemia. California Medicine 85 (3): 190–193.
- ↑ Jana, D. K., L. Romano-Jana (October 1973). Hypernatremic psychosis in the elderly: case reports. Journal of the American Geriatrics Society 21 (10): 473–477.
- ↑ Haensch, C. A., G. Hennen and J. Jorg (April 1996). [Reversible exogenous psychosis in thiazide-induced hyponatremia of 97 mmol/l]. Der Nervenarzt 67 (4): 319–322.
- ↑ Hafez, H., J. S. Strauss, M. D. Aronson, and C. Holt (June 1984). Hypokalemia-induced psychosis in a chronic schizophrenic patient. Journal of Clinical Psychiatry 45 (6): 277–279.
- ↑ Konstantakos, Anastasios K., Enrique Grisoni Hypomagnesemia. eMedicine. WebMD.
- ↑ Velasco, P. Joel, Manoochehr Manshadi, Kevin Breen, and Steven Lippmann (December 1999). Psychiatric Aspects of Parathyroid Disease. Psychosomatics 40 (6): 486–490.
- ↑ Rosenthal, M., I. Gil and B. Habot (1997). Primary hyperparathyroidism: neuropsychiatric manifestations and case report. Israel Journal of Psychiatry and Related Sciences 34 (2): 122–125.
- ↑ Nanji, A. A. (November 1984). The psychiatric aspect of hypophosphatemia. Canadian Journal of Psychiatry 29 (7): 599–600.
- ↑ Padder, Tanveer, Aparna Udyawar, Nouman Azhar, and Kamil Jaghab (December 2005) "Acute Hypoglycemia Presenting as Acute Psychosis" in Psychiatry online. Retrieved on 2006-09-27
- ↑ Larson, Michael Alcohol-Related Psychosis. eMedicine. WebMD.
- ↑ Soyka, Michael (March 1990). Psychopathological characteristics in alcohol hallucinosis and paranoid schizophrenia. Acta Psychiatrica Scandinavica 81 (3): 255–9.
- ↑ Gossman, William Delirium Tremens. eMedicine. WebMD.
- ↑ Sexton, J. D., D. J. Pronchik (September 1997). Diphenhydramine-induced psychosis with therapeutic doses. American Journal of Emergency Medicine 15 (5): 548–549.
- ↑ Lang, K., H. Sigusch, and S. Muller (December 8, 1995). [An anticholinergic syndrome with hallucinatory psychosis after diphenhydramine poisoning]. Deutsche medizinische Wochenschrift 120 (49): 1695–1698.
- ↑ Schreiber, W., A. M. Pauls and J. C. Kreig (February 5, 1988). [Toxic psychosis as an acute manifestation of diphenhydramine poisoning]. Deutsche medizinische Wochenschrift 113 (5): 180–183.
- ↑ Timnak, Charles, Ondria Gleason (January-February 2004). Promethazine-Induced Psychosis in a 16-Year-Old Girl. Psychosomatics 45 (1): 89–90.
- ↑ Official Journal of American Pediatrics - PEDIATRICS Vol. 108 No. 3 September 2001, p. e52
- ↑ de Paola, Luciano, Maria Joana Mäder, Francisco M.B. Germiniani, Patrícia Coral, Jorge A.A. Zavala, Djon J. Watzo, Jorge Kanegusuku, Carlos E.S. Silvado, and Lineu C. Werneck (June 2004). Bizarre behavior during intracarotid sodium amytal testing (Wada test): Are they predictable?. Arquivos de Neuro-Psiquiatria 62 (2B): 444–448.
- ↑ Sarrecchia, C., P. Sordillo, G. Conte, and G. Rocchi (October-December 1998). [Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication]. Annali Italiani di Medicina Interna 13 (4): 237–239.
- ↑ White, M. C., J. J. Silverman, and J. W. Harbison (February 1982). Psychosis associated with clonazepam therapy for blepharospasm. Journal of Nervous and Mental Disease 170 (2): 117–9.
- ↑ Jaffe, R., E. Gibson (June 1986). Clonazepam withdrawal psychosis. Journal of Clinical Psychopharmacology 6 (3): 193.
- ↑ Hallberg, R. J., K. Lessler and F. J. Kane (August 1964). Korsakoff-Like Psychosis Associated With Benzodiazepine Overdosage. American Journal of Psychiatry 121 (2): 188–189.
- ↑ Bergman, K. R., C. Pearson, G. W. Waltz, and R. Evans III year = 1980 (December 1980). Atropine-induced psychosis. An unusual complication of therapy with inhaled atropine sulfate. Chest 78 (6): 891–893.
- ↑ Varghese, S., N. Vettath, K. Iyer, J. M. Puliyel, and M. M. Puliyel (June 1990). Ocular atropine induced psychosis--is there a direct access route to the brain?. Journal of the Association of Physicians of India 38 (6): 444–445.
- ↑ Barak, Segev, Ina Weiner (September 13, 2006). Scopolamine Induces Disruption of Latent Inhibition Which is Prevented by Antipsychotic Drugs and an Acetylcholinesterase Inhibitor. Neuropsychopharmacology 32: 989.
- ↑ Kurzbaum, Alberto, Claudia Simsolo, Ludmilla Kvasha and Arnon Blum (July 2001). Toxic Delirium due to Datura Stramonium. Israel Medical Association Journal 3 (7): 538–539.
- ↑ Ettinger AB. "Psychotropic effects of antiepileptic drugs". Neurology. 2006 Dec 12;67(11):1916-25.
- ↑ 28.0 28.1 28.2 28.3 28.4 28.5 Diaz, Jaime. How Drugs Influence Behavior. Englewood Cliffs: Prentice Hall, 1996.
- ↑ Brady, K. T., R. B. Lydiard, R. Malcolm, and J. C. Ballenger (December 1991). Cocaine-induced psychosis. Journal of Clinical Psychiatry 52 (12): 509–512.
- ↑ Degenhardt, L, Smith J, Steel R, Johnstone CE, Frith CD (2003). Editorial: The link between cannabis use and psychosis: furthering the debate. Psychological Medicine 33: 3–6.
- ↑ Moore, TH, Zammit S, Lingford-Hughes A, Barnes TR, Jones PB, Burke M, Lewis G (28). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370: 319–28.
- ↑ Degenhardt L, Hall W, Lynskey M (2001). "Comorbidity between cannabis use and psychosis: Modelling some possible relationships." (PDF). Technical Report No. 121.. Sydney: National Drug and Alcohol Research Centre.. Retrieved on 2006-08-19.
- ↑ [Hall RCW, Zisook S. Paradoxical Reactions to Benzodiazepines. Br J Clin Pharmacol 1981; 11: 99S-104S}
- ↑ Lader M, Morton S. Benzodiazepine Problems. British Journal of Addiction 1991; 86: 823-828}
- ↑ Benzodiazepines: Paradoxical Reactions & Long-Term Side-Effects
- ↑ Hansson O, Tonnby B. [Serious Psychological Symptoms Caused by Clonazepam.] Läkartidningen 1976; 73: 1210-1211.