digoxin and Delirium

Topics: Arrhythmias, Cardiac; Delirium; Depression; Digitalis Glycosides; Digitoxin; Digoxin; Hallucinations; Heart Failure; Humans; Vision Disorders

Topics: Acute Kidney Injury; Aged, 80 and over; Atrial Fibrillation; Confusion; Delirium; Diagnosis, Differential; Digoxin; Electrocardiography; Female; Heart Failure; Humans; Immunoglobulin Fab Fragments; Lung Diseases; Medically Uninsured; Nausea; Poisoning; Radiography, Thoracic; Vomiting

A fulminant psychiatric disturbance, as the sole noncardiac manifestation of digitalis toxicity, emerged in a 85-year-old woman during treatment for congestive heart failure. Described more than a century ago as "digitalis delirium," the disorder is characterized by severe agitation, delusional thinking, assaultive behavior, and even death. Digoxin immune Fab therapy was begun because of the fulminant psychiatric manifestations of this toxic state and the clear danger of self-inflicted physical harm. Within 3 h of therapy, a complete and spectacular resolution of all mental symptoms was observed.

Topics: Aged; Aged, 80 and over; Delirium; Digitalis Glycosides; Digoxin; Female; Heart Failure; Humans; Immunoglobulin Fab Fragments

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.. 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.. 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.. 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.

Topics: Adverse Drug Reaction Reporting Systems; Benzodiazepines; Canada; Databases, Factual; Delirium; Digoxin; Hallucinations; Histamine Agonists; Humans; Methyldopa; Mood Disorders; Substance-Related Disorders

Topics: Aged; Delirium; Digoxin; Humans

Topics: Aged; Aging; Body Composition; Delirium; Digoxin; Drug Therapy, Combination; Female; Humans; Metabolic Clearance Rate

A case of anorexia, paranoid delusions, and lethargy associated with digoxin toxicity is presented here. The digitalis glycosides are among the most commonly used drugs in modern medicine, and as such, they frequently cause toxicity. Although cardiac side effects of digoxin are well recognized, less attention has been paid to potential CNS effects. Psychiatric manifestations, from calm disorientation to violent psychosis, tend to occur more often in elderly patients and may be the earliest or only sign of digitalis toxicity.

Topics: Aged; Anorexia; Delirium; Digoxin; Female; Humans; Paranoid Disorders; Sleep Stages

Topics: Age Factors; Aged; Delirium; Digitoxin; Digoxin; Female; Humans; Male; Middle Aged

The clinical course is described of a patient who took an overdose of 15 mg of digoxin in a suicidal attempt. He developed several cardiac arrhythmias like atrial fibrillation, atrial flutter, sino-atrial block. atrio-ventricular block 3 degree and ventricular extrasystoles. His plasma digoxin level rose to 38.7 ng/ml as determined by radioimmunoassay. He was treated with Aprindine and recovered without sequelae. A survey of the complications of acute massive digoxin intoxication is offered as well as a summary of treatment.

Topics: Arrhythmias, Cardiac; Delirium; Digoxin; Humans; Male; Middle Aged; Suicide

Topics: Bradycardia; Delirium; Digitalis; Digitalis Glycosides; Digitoxin; Digoxin; Gynecomastia; Humans; Lanatosides; Male; Neuritis; Paresthesia; Tachycardia; Thrombocytopenia; Toxicology; Trigeminal Neuralgia; Urticaria