Medications Causing Delirium

Delirium is not actually a form of dementia, but it is a medical condition that can mimic some forms of dementia and is often mistaken for it.  It is almost always reversible, for the most part, if caught early enough and treated appropriately.  There are a number of physical problems that can cause delirium, such as infection or head injury.  It can also be caused by certain medications, either primarily or as a possible side effect or interaction with another medication.  Care should always be taken, when prescribing these medications, especially to the elderly or the medically frail, in case their administration should result in delirium.  Here is a partial list of medications to be on the alert for:

—  Anticholinergics, antihistamines, antiparkinsonian agents, muscle relaxers, phenothiazines, tricyclic antidepressants

—  Sedatives, including barbiturates, benzodiazepines, and ethanol

—  Antidepressant drugs

—  Corticosteroids

—  Anticonvulsant drugs

—  Analgesic agents, such as narcotics, non-steroidal anti-inflammatory drugs (NSAIDs), opioids

—  Cardiovascular agents, such as antiarrhythmic agents, antihypertensive agents, Dixogin

—  Lithium

–Cimetidine

—  Antibiotics such as aminoglycosides, cephalosporins, penicillins

—  L-dopa

—  Antiemetics

—  Antiasthmatic agents

—  Immunosuppressive agents

Psychoactive substances that can cause delirium:

—  Ethanol

—  Marijuana

—  LSD

—  Amphetamines

—  Cocaine

—  Opiates

—  PCP

—  Inhalants

Poisons that cause delirium:

—  Solvents such as gasoline, kerosene, turpentine, benzene, and alcohols

—  Carbon monoxide

—  Refrigerants, Freon

—  Heavy metals such as lead, mercury, arsenic

—  Insecticides

—  Some mushrooms

—  Certain plants

—  Animal venoms

—  Carbon dioxide

(List adapted from one found in “Delirium:  The Mistaken Confusion,” by Debra Cason-McNeeley)

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