Abstract

A REVIEW ARTICLE ON DRUGS CAUSING THE MENTAL CONFUSION

Smita T., Bharat V., Anurag G.*, Pooja G., Anju G. and Adarsh G.

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Abstract

This reviews is based on the main neurological complications of the psychiatric drugs, in particular antipsychotics and antidepressants. The extrapyramidal syndromes include acute dystonia, parkinsonism, akathisia, tardive dyskinesia and tardive dystonia. Extrapyramidal symptoms (EPS) are less frequent with the atypical than with conventional antipsychotics but remain common in clinical practice partly due to lack of screening by health professionals. Serotonin toxicity comprises altered the mental state (agitation, excitement, confusion), neuromuscular hyperactivity (tremor, clonus, myoclonus, hyper-reflexia) and autonomic hyperactivity and occurs on a spectrum. Severe cases, has termed serotonin syndrome, usually follow the co-prescription of drugs that increase serotonergic transmission by different pathways, for example a monoamine oxidase inhibitor (MAOI) and a selective serotonin reuptake inhibitor (SSRI). Most antipsychotics and antidepressants lower the seizure threshold and can cause seizures; the risk is greater with clozapine than with other atypical antipsychotics and greater with tricyclic antidepressants (TCAs) than with SSRIs. In the randomised controlled trials in elderly patients with dementia atypical antipsychotics are associated with a higher risk of stroke and death than placebo. Cohort studies suggest that conventional drugs carry at least the same risk. Cessation of treatment with antipsychotics and antidepressants can lead to a wide range of discontinuation symptoms which include movement disorders and other neurological symptoms. Clinicians need to be familiar with strategies to reduce the risk of these adverse events and to manage them when they arise. Their occurrence needs to be balanced against the benefits. Psychiatric drugs in terms of efficacy and improved quality of life in a range of disorder.

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