Neuropsychiatric adverse drug reactions: passive reports to Health and Welfare Canada's adverse drug reaction database (1965-present). 1994

S B Patten, and E J Love
University of Calgary, Alberta, Canada.

OBJECTIVE Since 1965, Health and Welfare Canada has operated an adverse drug reaction (ADR) program. The program accepts spontaneous reports of adverse drug reactions, and maintains an ADR database. The purpose of this article is to summarize the Psychiatric ADRs reported to this database since 1965. The nature of the information prohibits its use in the evaluation of epidemiological hypotheses about the etiology of drug-induced mental disorders. However, in an exploratory sense, the contents of the database may contribute to the development of epidemiological hypotheses about the etiology of drug-induced mental disorders. Of particular interest are areas of apparent contradiction between the contents of the database and the clinical literature. METHODS The database was searched for reports of ADRs to a group of drugs which have been frequently implicated in causing psychiatric toxicity. All reports characterized as "psychiatric disorders" were down-loaded from the database for the analysis (n = 1822). The reports were further classified into nine categories according to the type of psychiatric symptoms described. RESULTS There were several reports of hallucinations caused by methyldopa, and also several reports of benzodiazepine-induced hallucinations and encephalopathy. These reactions have not been described in the literature. Also, there were few reports of digoxin-induced organic depression, and an absence of reports of organic mania induced by H-2 blockers, despite descriptions of these sorts of reactions in the clinical literature. CONCLUSIONS Further research is needed to define the neuropsychiatric toxicity associated with medical drugs. Clinicians must continue to consider the potential role of medications in the etiology of psychiatric symptoms.

UI MeSH Term Description Entries
D008750 Methyldopa An alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. Its primary clinical use is as an antihypertensive agent. Methyldopate,alpha-Methyldopa,Aldomet,Alphamethyldopa,Apo-Methyldopa,Dopamet,Dopegit,Dopegyt,Dopergit,Hydopa,Meldopa,Nu-Medopa,Sembrina,alpha-Methyl-L-Dopa,Apo Methyldopa,Nu Medopa,alpha Methyl L Dopa,alpha Methyldopa
D002170 Canada The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.
D003693 Delirium A disorder characterized by CONFUSION; inattentiveness; disorientation; ILLUSIONS; HALLUCINATIONS; agitation; and in some instances autonomic nervous system overactivity. It may result from toxic/metabolic conditions or structural brain lesions. (From Adams et al., Principles of Neurology, 6th ed, pp411-2) Delirium of Mixed Origin,Subacute Delirium,Delirium, Subacute,Deliriums, Subacute,Mixed Origin Delirium,Mixed Origin Deliriums,Subacute Deliriums
D004077 Digoxin A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666) Digacin,Digitek,Digoregen,Digoxina Boehringer,Digoxine Nativelle,Dilanacin,Hemigoxine Nativelle,Lanacordin,Lanicor,Lanoxicaps,Lanoxin,Lanoxin-PG,Lenoxin,Mapluxin,Boehringer, Digoxina,Lanoxin PG,Nativelle, Digoxine,Nativelle, Hemigoxine
D006212 Hallucinations Subjectively experienced sensations in the absence of an appropriate stimulus, but which are regarded by the individual as real. They may be of organic origin or associated with MENTAL DISORDERS. Hallucination of Body Sensation,Hallucinations, Auditory,Hallucinations, Dissociative,Hallucinations, Elementary,Hallucinations, Formed, of People,Hallucinations, Gustatory,Hallucinations, Hypnagogic,Hallucinations, Hypnapompic,Hallucinations, Internal Body Sensation,Hallucinations, Kinesthetic,Hallucinations, Mood Congruent,Hallucinations, Mood Incongruent,Hallucinations, Olfactory,Hallucinations, Organic,Hallucinations, Reflex,Hallucinations, Sensory,Hallucinations, Somatic,Hallucinations, Tactile,Hallucinations, Verbal Auditory,Hallucinations, Visual,Hallucinations, Visual, Formed,Hallucinations, Visual, Unformed,Auditory Hallucination,Auditory Hallucination, Verbal,Auditory Hallucinations,Auditory Hallucinations, Verbal,Body Sensation Hallucination,Body Sensation Hallucinations,Dissociative Hallucination,Dissociative Hallucinations,Elementary Hallucination,Elementary Hallucinations,Gustatory Hallucination,Gustatory Hallucinations,Hallucination,Hallucination, Auditory,Hallucination, Dissociative,Hallucination, Elementary,Hallucination, Gustatory,Hallucination, Hypnagogic,Hallucination, Hypnapompic,Hallucination, Kinesthetic,Hallucination, Mood Congruent,Hallucination, Mood Incongruent,Hallucination, Olfactory,Hallucination, Organic,Hallucination, Reflex,Hallucination, Sensory,Hallucination, Somatic,Hallucination, Tactile,Hallucination, Verbal Auditory,Hallucination, Visual,Hypnagogic Hallucination,Hypnagogic Hallucinations,Hypnapompic Hallucination,Hypnapompic Hallucinations,Kinesthetic Hallucination,Kinesthetic Hallucinations,Mood Congruent Hallucination,Mood Congruent Hallucinations,Mood Incongruent Hallucination,Mood Incongruent Hallucinations,Olfactory Hallucination,Olfactory Hallucinations,Organic Hallucination,Organic Hallucinations,Reflex Hallucination,Reflex Hallucinations,Sensory Hallucination,Sensory Hallucinations,Somatic Hallucination,Somatic Hallucinations,Tactile Hallucination,Tactile Hallucinations,Verbal Auditory Hallucination,Verbal Auditory Hallucinations,Visual Hallucination,Visual Hallucinations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001569 Benzodiazepines A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring. Benzodiazepine,Benzodiazepine Compounds
D016208 Databases, Factual Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references. Databanks, Factual,Data Banks, Factual,Data Bases, Factual,Data Bank, Factual,Data Base, Factual,Databank, Factual,Database, Factual,Factual Data Bank,Factual Data Banks,Factual Data Base,Factual Data Bases,Factual Databank,Factual Databanks,Factual Database,Factual Databases
D016907 Adverse Drug Reaction Reporting Systems Systems developed for collecting reports from government agencies, manufacturers, hospitals, physicians, and other sources on adverse drug reactions. Adverse Drug Reaction Reporting System,Drug Reaction Reporting Systems, Adverse
D017442 Histamine Agonists Drugs that bind to and activate histamine receptors. Although they have been suggested for a variety of clinical applications histamine agonists have so far been more widely used in research than therapeutically. Histamine H1 Agonists,Histamine H2 Agonists,Histamine H3 Agonists,H1 Agonist,H1 Agonists,H2 Agonist,H2 Agonists,H3 Agonist,H3 Agonists,Histamine Agonist,Histamine H1 Agonist,Histamine H1 Receptor Agonist,Histamine H1 Receptor Agonists,Histamine H2 Agonist,Histamine H2 Receptor Agonist,Histamine H2 Receptor Agonists,Histamine H3 Agonist,Histamine H3 Receptor Agonists,Histaminergic Agonist,Histaminergic Agonists,Agonist, H1,Agonist, H2,Agonist, H3,Agonist, Histamine,Agonist, Histamine H1,Agonist, Histamine H2,Agonist, Histamine H3,Agonist, Histaminergic,Agonists, H1,Agonists, H2,Agonists, H3,Agonists, Histamine,Agonists, Histamine H1,Agonists, Histamine H2,Agonists, Histamine H3,Agonists, Histaminergic,H1 Agonist, Histamine,H1 Agonists, Histamine,H2 Agonist, Histamine,H2 Agonists, Histamine,H3 Agonist, Histamine,H3 Agonists, Histamine

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