Agitation/psychosis caused

Increases in norepinephrine and dopamine centrally can cause CNS side effects such as insomnia, agitation, psychosis and substance abuse... 

A. Mild to moderate intoxication may cause sinus tachycardia, elevated temperature, flushing, diarrhea, vomiting, headache, anxiety, agitation, psychosis, and confusion. 

At the doses usually used by stimulant abusers, euphoria and wakefulness are accompanied by a sense of power and wellbeing. At higher doses, restlessness, agitation, and acute psychosis may occur, accompanied by hypertension and tachycardia. Prolonged muscular hyperactivity can cause dehydration and eventually hypotension. Seizures and muscle activity may contribute to hyperthermia and rhabdomyolysis. Body temperatures as high as 42°C (107.6°F) have been recorded. Hyperthermia can cause brain damage, hypotension, coagulopathy, and renal failure. 

Caution [C, /-] Contra Active varicella Infxn, serious Infxn except TB, fungal Infxns Disp Table VI-1 SE T Appetite, hyperglycemia, -i- K+, osteoporosis, nervousness, insomnia, steroid psychosis, adrenal suppression, fat redistribution, hypertension EMS Acute adrenal insufficiency can result w/ hypotension and shock if chronic steroids are abruptly stopped. Sxs can include abd pain, tach, confusion, hypotension, and chills. Support w/ IV fluids and steroid admin. GI perforation w/ chronic use. Can T Infxn risk and fracture risk from osteoporosis. Steroid psychosis can cause anxiety, agitation, euphoria, insomnia, mood swings, personality changes, depression, and memory loss usually at does of prednisone over 20 mg/d OD Acute hyperglycemia supportive care... 

Side effects. The most common side effects are headache, nausea and vomiting, diplopia, dizziness, ataxia and tremor. There are also reports that lamotrigine can cause such psychiatric side effects as aggression, agitation, confusion, hallucinations and psychosis, some of these effects possibly being associated with a reduction in the glutamatergic system. Rashes are a frequent side effect, occurring in up to 5% of patients. Usually rashes are mild but occasionally can be severe and amount to a Stevens-Johnson syndrome. The severe rash occurs more commonly in children. 

Tricyclic antidepressants + phenothiazines —> additive anticholinergic effects that can cause psychosis and agitation. 

In inferior MCA trunk occlusion infarctions of the lateral surface of the temporal lobe and the inferior parietal lobe may occur (Olsen 1991 Ringelstein et al. 1992). Motor or sensory deficits may not be severe, but visual field deficit and sensory aphasia in left sided infarctions and constructional apraxia in right sided lesions occur (Geschwind 1975 Spinazzola et al. 2003). Right temporal lesions cause agitation and confusion resembling an organic psychosis (Ferro 2001). 

Venlafaxine (Effexor), approved by the FDA in December 1993, was described in more detail early in this chapter. It is one of the newer antidepressants implicated in causing suicidality. It is a NSRI that also strongly inhibits the reuptake of epinephrine. Its profile is very similar to the SSRIs in producing stimulation, including anxiety, nervousness, insomnia, anorexia, and weight loss. It causes the various emotional and behavioral abnormalities that go along with stimulation, such as agitation and mania, and has been associated with hostility, paranoid reaction, psychotic depression, and psychosis. It can cause hypertension. 

Reynaldo quickly developed akathisia—agitation accompanied by a compulsive need to move—as well as other maniclike symptoms of irritability and anxiety. As described in chapters 6 and 7, antidepressant-induced akathisia can cause violence, suicide, psychosis, and an overall worsening of the patient s mental condition. 

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