Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of acute psychotic illness following sudden withdrawal from high daily doses of benzodiazepines were associated with agitation and confusion. Disorientation was prominent in two of the patients. None of the patients had had previous psychotic episodes. The condition of all patients was reversed dramatically with hypnotic drugs. Gradual withdrawal was successfully accomplished without relapse, with a follow-up of as much as one year. To our knowledge, this is the first such series in the literature.
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PMID:Benzodiazepines and withdrawal psychosis. Report of three cases. 1 58

The author reports five cases of relatively young women, in good general health, except that one of them had alcoholic liver disease, who presented a confusional state on taking neuroleptics: a widely used butyrophenone, prescribed for a psychotic condition. Owing to the low incidence of this side effect, these clinical cases were worth reporting. Furthermore, a trial of interpretation led us to believe that these reductions in consciousness were due to resistance to treatment.
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PMID:[Mental complications of neuroleptic drugs. Confusional oneiric states]. 2 40

Propanolol use can result in a severe toxic psychosis. In this case, mild perceptual errors progressed eventually to a severe confusional state over a period of 6 months. Life threatening cardiac symptoms forced the continuation of propanolol until the bundle of His was surgically severed. Despite the prolonged delirium, the patient showed complete clearing of sensorium within 2 weeks after cessation of the drug. The differential diagnosis of delirium in the cardiac patient needs to include consideration of propanolol use.
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PMID:Prolonged delirium with propanolol. 3 71

269 patients suffering from progredient, chronic either primary or secundary cerebral diseases (Parkinson's disease, cerebral vascular diseases, cerebral atrophic dystrophy, Huntington's chorea, muliple sclerosis have been studied in the last two years. 44 of these patients developed pharmaco-toxic psychoses during drug treatment (low and medium dosis). The psycho-pathological rating resulted in an acute organic brain syndrome with predominance of confusion, sometimes progressing to delirium. EEG was changed during the psychotic stage. These changes cannot be decided from organic psychoses, which are not related to drugs. Patients with Parkinson's disease showed a relatively high incidence to psychoses during drug treatment (51.47%). In patients without Parkinson's disease, but on treatment with antidepressants, neuroleptics, diuretics and digitalis, pharmacotoxic psychoses only could be observed in 4.4% of the patients. However, the same group of patients showed an acute organic brain syndrome in 12.43%, when not on treatment. Combined treatment with L-DOPA plus peripherally acting decarboxylase inhibitors resulted in a high incidence to psychoses in idiopathic Parkinsonism but the same dosis produced this side effect only in a few patients with cerebral atrophic dystrophy. The ratio was 5:1 between the former group and the later one. That means, that L-DOPA is a much more psychotoxic substance in Parkinsonism when compared to other cerebral diseases. These pharmacotoxic psychoses could be correlated with the progredience of the disease. These pharmacotoxic psychoses are not only dependent from age and duration of treatment. Evidence exist, that there might be a correlation between the incidence for pharmacotoxic psychoses and the lack of surviving dopaminergic neurons in the nigro-striatal areas. Treatment with very low doses of neuroleptics suppresses pharmacotoxic psychoses but allow a further anti-Parkinson therapy which is of vital necessity.
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PMID:[Acute pharmacotoxic psychoses in patients with chronic cerebral disorders]. 3 35

A twenty-seven year old women with meningo-encephalitis and paranoid symptoms is presented. The patient was admitted to a psychiatric unit where, two months previously, her brother had been under treatment for a paranoid schizophrenic episode. The diagnostic lumbar puncture was performed after several days of increasing periods of disorientation, stupor, incontinence, posturing, and perseveration. There was no fever, no signs of meningeal irritation, and no localizing neurologic deficit. The problem of recognizing organic brain disease presenting as an acute psychotic episode is discussed. In this case, the positive family history was given inappropriate emphasis, while the good pre-morbid adjustment of the patient and the symptoms of confusion and headache were inadequately considered. Viral meningo-encephalitis, particularly that due to herpes simplex, often presents with a picture of behavioral abnormalities and minimal physical signs, and is easily confused with a functional process.
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PMID:Meningo-encephalitis presenting as an acute paranoid psychosis. 21 81

Language disorder is often mistaken for confusion, psychosis, or memory loss, and thorough evaluation may require much time. A simple beside examination can often separate aphasic syndromes, and the anatomic location of the lesion can be inferred. Speech therapy, although not entirely satisfactory, is helpful in most patients.
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PMID:Language dysfunction in cerebrovascular disease. 26 60

In this double-blind study, haloperidol (n = 15) and thiothixene (n = 15), administered parenterally in emergency rooms and outpatient facilities to 30 acutely excited, agitated psychotic patients in hourly doses of 4 mg. or 8 mg., as needed over a four-hour period (total dosage ranging from 4 to 32 mg.), achieved rapid tranquilization in 30 patients. Significant improvement was shown over a six-hour period on BPRS Total Score, the four factors--Thinking Disorder, Anergic state, Excitement and Disorientation, and Depression and also on hourly ratings of 17 symptoms of a Psychiatric Target Symptom Profile. No significant differences were found between the haloperidol-treated and thiothixene-treated groups. Few adverse reactions were noted, all of them mild, the most frequent being drowsiness in six patients.
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PMID:Relative efficacy of parenteral haloperidol and thiothixene for the emergency treatment of acutely excited and agitated patients. 33 70

Thirty-six patients with advanced ovarian carcinoma, 21 who had not responded to conventional surgery and irradiation therapy and 15 who had not responded to conventional surgery, irradiation therapy, and chemotherapy, were treated in a phase II study with Leo 1031. Objective responses were obtained in ten (28%) of the 36 patients (two complete and eight partial responses). An additional 11 (32%) patients had stable disease. The two complete responders were in remission for 4 months. During remission, all of the patients had an improved quality of life. Myelosuppression of varying severity occurred in 11 patients; three of these patients died from their complications. Two patients developed reversible confusion and one patient became psychotic. Eight patients became euphoric during treatment. Leo 1031 might be worthwhile as a palliative chemotherapy for patients with advanced ovarian carcinoma, but the risk of euphoria must always be considered since it can lead to voluntary overdosage.
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PMID:Phase II study of Leo 1031 (prednimustine) in advanced ovarian carcinoma. 37 98

Six patients ranging in age from 42 to 69 with no prior history of seizure disorder presented an acute prolonged or intermittent confusional state, with or without psychotic symptoms, as an ictal manifestation. The EEGs demonstrated protracted generalized spike and wave discharges, but full diagnostic evaluation disclosed no evident cause for the seizures. All promptly responded to small amounts of intravenous diazepam and subsequent oral phenytoin and phenobarbital. Three of the six patients had focal spike or sharp wave discharges on EEGs recorded subsequently, suggesting that the episodes may reflect secondary generalized seizures in some cases. These cases do not fit in the classic category of petit mal status and appear to be a distinct entity.
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PMID:Acute prolonged confusion in later life as an ictal state. 41 52

Over-the-counter (OTC) hypnotic preparations (such as Sominex, Nytol, and Sleep Eze) were implicated in 21 of the 773 admissions to Massachusetts General Hospital due to psychotropic drug overdosage between 1962 and 1975. Ten of the 21 cases had manifestations of central anticholinergic toxicity ("atropine-like psychosis"), such as hallucinations, delirium, and confusion. However, all patients recovered rapidly and without sequelae. Specific therapy (i.e., physostigmine) was rarely required. Thus OTC hypnotic overdosage commonly produces "toxic psychosis." Fortunately, intoxication is usually of short duration and relatively benign.
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PMID:Self-poisoning with over-the-counter hypnotics. 50 80


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