There are many potential causes of mental disorders, including the role of genes or environmental conditions in their pathogenesis. However, problems such as hallucinations, lowered or elevated mood can also be caused by... medication used by the patient. Many preparations can lead to drug-induced psychiatric disorders - for example, both hypertension and anti-inflammatory glucocorticosteroids can be the cause.
Table of contents:
- Which drugs can lead to psychiatric disorders?
- Who is particularly predisposed to drug-induced mental disorders?
- Should the threat of drug-induced mental disorders prompt patients to give up the drugs in question?
Every medical speciality emphasises the importance of the patient's personal examination, commonly referred to as the medical history, in the process of diagnosing a patient. In psychiatry, however, the patient interview is of particular importance. This is not only because psychiatric diagnoses are made mainly on the basis of the medical history. When any psychiatric disorder is suspected in a person, the first aspect to be taken into account is whether the cause of the patient's problems is not organic factors or a substance use disorder.
It is commonly associated that mental problems can be led to by the use of psychoactive substances, such as alcohol or various drugs. However, mental disorders can also be caused by the patient's medication, and we are not talking about people who abuse pharmaceutical preparations, but those who use medication according to all indications.
Which medicines can lead to mental disorders?
Glucocorticosteroids (ICS) are probably best known for causing psychiatric disorders. These drugs are widely used in medicine - they are used by dermatologists and rheumatologists for their anti-inflammatory and immunosuppressive effects, among others, and are also sometimes prescribed to patients with respiratory diseases. The psychological disturbances induced by glucocorticosteroids vary widely - the type of problems that arise depends, among other things, on the length of treatment with these drugs. In short-term treatment, euphoria and hypomania are the most common psychiatric disorders following ICS treatment. In contrast, depressive episodes are more common in patients taking these drugs chronically. However, ICSs may not only lead to mood disorders; psychotic episodes are also a possible side effect.
Medication use and mental disorders, photo: panthermedia
Other drugs that can cause mental disorders are interferon preparations. These substances are used, among others, in the treatment of multiple sclerosis. In the case of interferons, most talk about their risk of provoking a depressed mood episode, sometimes reaching the intensity of depression.
The risk of drug-induced psychiatric disorders also exists with cardiovascular preparations. Examples of pharmaceuticals that may have such adverse effects include beta-blockers and angiotensin-converting enzyme inhibitors (ACE inhibitors). With the former, patients may experience hallucinations, depressive disorders or increased nightmares. ACE inhibitors, on the other hand, can lead to states of depressed mood, but also to disorders of consciousness or psychotic disorders.
It is interesting to note that drug-induced mental disorders may also be associated with the use of... psychotropic drugs. This phenomenon may particularly affect patients with bipolar affective disorder (BPAD). BPAD is not always immediately diagnosed in these individuals - sometimes, due to the predominant symptoms of depressed mood, patients are diagnosed with a depressive disorder and are prescribed antidepressants. Administering antidepressants to BPAD sufferers, on the other hand, can lead to the side effect of triggering a manic episode.
Who is particularly predisposed to drug-induced mental disorders?
Elderly patients are particularly at risk of developing drug-induced mental disorders. This phenomenon is due to several different mechanisms. Firstly, the metabolism of drugs, including their absorption, conversion and excretion, is significantly altered in the elderly. It is also important to note that elderly patients are often treated with many different agents from different drug classes. This can lead to various drug-drug interactions, some of which may be conducive to the development of drug-induced mental disorders.
Should the threat of drug-induced mental disorders induce patients to give up the medication in question?
Every drug can have some adverse effects. In fact, a glance at the leaflet of any pharmaceutical can usually reveal a very long list of all possible adverse effects. However, this does not mean that every patient will experience side effects of pharmacotherapy. It should also be emphasised that patients are prescribed drugs for a reason: before a doctor prescribes any preparation, he first makes sure that the patient actually has an indication for its use.
The risk of drug-induced mental disorders - after taking the above-mentioned drugs, but also many others - does indeed exist. However, this does not mean that any medication that may have such effects should be avoided outright.
Support from a psychiatrist, photo: panthermedia
The most important thing with drug-induced mental disorders is to be aware that they can occur. This is when it is possible for both the doctor and those close to the patient to be vigilant. If you experience a significant lowering or elevation of your mood or psychotic symptoms, you should simply visit your doctor as soon as possible. It is essential to inform the specialist of which medication the patient is taking - sometimes it is not necessary to use psychotropic medication to resolve psychotic disorders, and it may be sufficient to reduce or stop the medication that caused them.
