Review article

https://doi.org/10.24869/psyd.2022.11

MEDICATION-INDUCED PSYCHOTIC DISORDER. A REVIEW OF SELECTED DRUGS SIDE EFFECTS

Anna Niebrzydowska ; Adult Psychiatry Scientific Circle, Department of Developmental, Psychotic and Old Age Psychiatry, Medical University of Gdansk, Gdansk, Poland
Jakub Grabowski ; Department of Developmental, Psychotic and Old Age Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland

Abstract

Background: Medication-induced psychotic disorder (MIPD) is a diagnostic term for a syndrome with symptoms such as
hallucinations and delusions directly related to drug intake. The purpose of this review is to report and comment on the current
knowledge about pathomechanisms, risk factors, symptoms, and treatment of MIPD caused by selected widely used medications.
Methods: PubMed, Scopus, and Google Scholar databases were searched for articles on MIPD published prior to January 2021
using search terms ‘psychosis’ OR ‘psychotic disorder’ AND ‘side effects’ combined with certain medications group. The initial
search was then narrowed to medications with more pathomechanisms than only direct dopamine-inducing activity that are widely
used by clinicians of various medical specialties.
Results: Steroids, antiepileptic drugs, antimalarial drugs, and antiretroviral drugs can induce psychosis with persecutory
delusions and auditory hallucinations as the most frequently reported symptoms. Mood changes and anxiety may precede psychosis
after steroids and antimalarials. Psychiatric history and female sex are risk factors for most of the MIPD. Treatment involves
cessation of the suspected drug. Administration of atypical antipsychotic drugs may be helpful, although there is insufficient data to
support this approach. The latter should be done with careful consideration of pharmacokinetic and pharmacodynamic interactions.
Conclusions: MIPD is a rare condition. The appearance of psychotic symptoms during systemic treatment may be associated
with administered medications, psychiatric comorbidity, or be a part of the clinical picture of a certain disorder. Furthermore,
sometimes it may be challenging to distinguish MIPD from delirium. Therefore, we consider that the key to proper management of
MIPD is a thorough differential diagnosis.

Keywords

steroids; anticonvulsants : antimalarials : anti-retroviral agents; substance-related disorders

Hrčak ID:

275931

URI

https://hrcak.srce.hr/275931

Publication date:

3.5.2022.

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