When in quite recent times I consulted in 33 hospitals (figuratively speaking, in fact, there were only 4 of them), I was always in some confrontation with somatic doctors for mental disorders. I wrote about it more than once. The fact is that when a person is “fooled”, all immediately begin to claim that he has schizophrenia and he urgently needs to be transferred to a mental hospital. This is the easiest solution and the existence of symptomatic (due to somatic diseases) and pharmacogenic psychoses do not want to believe. It’s not that the doctors are wrong (although they are also wrong). The development of psychosis or any mental side effects of the plan largely depends on the person – from it’s genetics, comorbidities, status of the brain, and the fact that he’s Chiharu takes (or relatives give him) for a speedy recovery. This was one such episode in my life when I consulted Granny with long-term current psychosis and prescribed her a course of Seroquel in a small dose. Two days she was very much nothing, and the third daughter, remembering my colorful stories about the impact of high pressure on the brain, decided to “treat” the pressure. You don’t think of your daughters as anything, just for the best of reasons. They gave her 3 full clonidine pills for 12 hours. Granny dropped the pressure from her working systolic (upper) 180 to 70. Against the background of such a deafening effect, the phenomena of psychosis not only returned, but also intensified. Relatives were to understand about the “poisonous” medicine, which “not only does not help, but also does worse.” In their understanding of clonidine-generally mint tablet, from which no harm, but only benefit.

So that’s what I’m saying. I’m talking about the fact that there are a whole bunch of somatic drugs that can cause psychiatric side effects. Note that it is not disease, and the effects. That is, when a person stops taking them or goes to another group of drugs then everything becomes normal with him. So if a person started taking a new drug and” screwed up ” do not hurry to write it in schizophrenics.

In fact, drugs, the list of side effects which include mental disorders, is large enough. Their 65%. All list it for a long time, but we can identify individual groups that are most often the cause of mental side effects.


– Affect the nervous system. Some of them also cause mental disorders. Depends on what? All drugs can be divided into 2 groups of water-soluble and fat-soluble. Water-soluble excreted by the kidneys and hardly penetrate the brain. The brain loves fat-soluble drugs, they penetrate well through the blood-brain barrier. Therefore, less water soluble atenolol penetrates into brain tissue than fat-soluble metoprolol and propranolol. If you compare the concentration of water and fat-soluble drugs in the brain, the latter will be there 20 times more. Therefore, in terms of side effects metoprolol and propranolol are the most likely candidates. They can cause drug delirium and psychosis. In addition, their side effects are associated with sedation, nightmares, depression. In 1967, it was reported that more than 50% of patients taking propranolol may experience dysphoria ( a maliciously dreary mood) and depression, with symptoms that may occur and become acute and increase gradually. However, the question of depression caused by drugs in this group remains open. There are studies confirming this plunging position, as well as refuting it.

ACE inhibitors

– This group also affects the Central nervous system. From 4 to 8% of patients experience a state of some activation or excitation. 2% of patients stop taking the drug due to side effects of the mental plan. They include anxiety, mania (high spirits), insomnia, weakness, paresthesia (crawling), and hallucinations. Sedation occurs in 5% of patients. Although in General the drug itself slightly improves mood, there were cases of depression caused by drugs in this group. Also described are cases of psychosis that occurred during the administration of ACE inhibitors.


– Is a Central alpha agonist, i.e. it acts on the alpha-adrenergic system of the brain, exciting it. This system is responsible for the regulation of awakening, as well as plays a role in the development of depression and anxiety. More than 1/3 of patients (35%) taking clonidine experience drowsiness and sedation, 3% anxiety, 1% depression and the same amount of insomnia. States of confusion, delirium, hypomania or psychosis occur in less than 1% of cases.


– Cause delirium, psychosis with delirium, anxiety, motor anxiety, hypomania.


– Can cause hillside-induced encephalopathy, which is characterized by sedation, apathy, depression and psychosis. In this case, patients can develop psychosis, even if the level of the drug in the blood is within normal limits.

Statins (Cholesterol-reducing drugs)

– Can cause depression and increase the risk of suicide, although opinions on this are not clear.

Corticosteroid hormones

– Most often affect mood, to a lesser extent they develop delirium. Among other side effects include drowsiness, insomnia, euphoria, depression, psychosis, personality changes, anxiety, motor anxiety. Overall, more than 18% of patients undergoing therapy drugs in a dose of 80 mg per day develop mental symptoms. Among those who received prednisone for the treatment of asthma, many found signs of mania (painfully high mood). However, among those who were depressed before the start of therapy, the condition did not deteriorate. On the contrary, persons with previous treatment of post-traumatic stress disorder have noted such deterioration in themselves. In General, it was noted that during short courses of therapy with corticosteroids, mania occurs, with prolonged depression. Side effects occur during the first 2 weeks from the start of therapy. In severe cases, when hormones can’t be reversed patients assigned to concomitant therapy with psychotropic drugs. It is assumed that women have a higher risk of developing mental complications, but not all studies confirm this.

Anabolic steroids

– Have limited medical use, but are actively used by bodybuilders and similar citizens to increase muscle mass. These drugs are dangerous in terms of the development of acute delirium (paranoid), delirium, mania, euphoria, attacks of rage, aggression, significant mood swings and irritability. The effects depend on the dose. The higher it is, the greater the risk of such complications.


– According to some uncertain data cause depression, but the data are not accurate.

Hormonal contraceptives

– In addition, there is evidence that estrogens on the contrary cause mood enhancement. But there are several works on this account, which contradict each other.


– Often cause side effects on the mental plane. Penicillins can cause depression, anxiety and hallucinations. Cephalosporins cause delirium, especially in patients with concomitant kidney disease. Jainology such as ciprofloxacin and ofloxacin, less than 1% of cases cause anxiety, irritability, drowsiness, tremors, insomnia, mania, psychosis, depression, seizures and catatonia. Also, mental disorders can occur during the reception of sulfonamides, tetracycline, etc. However, the most well-known in terms of the development of mental disorders anti-tuberculosis drug isoniazid. During therapy with this drug, delirium, mania, depression and psychosis occur.

Antiviral drugs

– Especially when administered intravenously can cause drowsiness, anxiety, hallucinations and delirium. The same disorder can cause another drug for the treatment of herpetic infection-foscarnet. Didanosine, a drug for the treatment of HIV causes drowsiness in 5-7% of patients, 2% depression, delirium and anxiety, 25% mood instability, 1% delusional disorders.

Tablets “from a cold”

– As a rule, contain a number of drugs of various kinds and can provoke atropine-like psychoses with confusion, disorientation, hallucinations of a frightening character. The data is particularly dangerous in patients receiving antidepressant group of MAO inhibitors.

Stomach pills.

– The most common are proton pump inhibitors (omez) and H2 – antagonists (famotidine, ranitidine, etc.) Although the side effects ( confusion, depression, motor anxiety, hallucinations) from these drugs are widely known, especially in elderly patients with liver and kidney failure, they occur only in 0,2%. However, it is necessary to know that these effects may occur not immediately, but after a time. So when taking ranitidine, they can occur for 4-8 weeks of treatment, cimetidine 2-3 weeks ( excluding delirium, which can occur after 24-48 hours). All symptoms are usually resolved self after 3 days after discontinuation of the drug. In addition it should be borne in mind that discontinuation of ranitidine cimetidine may experience a withdrawal syndrome characterized by anxiety, insomnia and irritability. You should also know. That cimetidine increases the concentration of tricyclic antidepressants in the blood, and increases their toxicity.

Tablets “analgesics”

– Perhaps, the most popular group of drugs in the masses, which are taken without a doctor’s prescription. They can cause quite serious side effects, such as mania, psychosis, depression and delirium in the elderly. The last complication occurs frequently on ketorol.

Well, that’s the list. The list is not for you to throw out all the pills that are included in it and not for you to give up the treatment that was prescribed to you. Taking many drugs is vital, and a person can not live without them. And to if you or your family something happens in terms of you need to pay attention to what drugs a person takes at the moment. Canceling the drug or replacing it with another leads to a significant improvement in a short period of time. If such a replacement is not possible, then additional treatment with psychotropic drugs is prescribed. And most importantly. Be careful with self-medication. Some tablets can aboutits. I’m talking about the abuse of non-addictive drugs.