And hallucinations

Psychoses. Major thought disorders involving distorted perception and hallucinations. 

A wide variety of perceptual, cognitive, and emotional experiences may be encountered after the use of PCP. Abusers seek euphoria, which develops within minutes after smoking and is accompanied by a sense of warmth and numbness, as well as unusual delusions and hallucinations. 

The main disturbance in inhalant intoxication delirium is a reversible decrease in the level of consciousness and awareness of the environment, which includes an inability to focus, sustain, or shift attention. The intoxicated person is confused and easily distracted by irrelevant stimuli and difficult to engage in a meaningful conversation. He or she may also exhibit prominent disorientation, short- and long-term memory deficits, language disturbances, and perceptual disturbances that may include illusions and hallucinations. Other prominent features associated with inhalant intoxication delirium are... 

Depression and mania are both affective disorders but their symptoms and treatments are quite distinct. Mania is expressed as heightened mood, exaggerated sense of self-worth, irritability, aggression, delusions and hallucinations. In stark contrast, the most obvious disturbance in depression is melancholia that often co-exists with behavioural and somatic changes (Table 20.1). Some individuals experience dramatic mood swings between depression and mania. This is known as "bipolar disorder which, like mania itself, is treated with lithium salts or neuroleptics. 

Initially, most prominent effect is elated mood, although depression may occur hypervigilance and anxiety that may progress to panic with high doses or chronic use, may see impairment of judgment, violence to others or self, paranoia or psychosis with delusions and hallucinations (hallucinations are generally tactile or auditory, rarely visual) an increase in motor activity is common compulsive or stereotyped behavior (e.g., skin picking) may be seen severe intoxication may result in a self-limited delirium... 

Patients presenting with odd behaviors, illogical thought processes, bizarre beliefs, and hallucinations should be assessed for schizophrenia. 

Neurological Signs and Symptoms in Adults. The most severe neurological effect of lead in adults is lead encephalopathy, which is a general term to describe various diseases that affect brain function. Early symptoms that may develop within weeks of initial exposure include dullness, irritability, poor attention span, headache, muscular tremor, loss of memory, and hallucinations. The condition may then worsen, sometimes abruptly, to delirium, convulsions, paralysis, coma, and death (Kumar et al. 1987). Histopathological findings in fatal cases of lead encephalopathy in adults are similar to those in children (see discussion below). 

Dizziness, redness, nausea, vomiting and hallucinations were reported (Vogel and Kirkendall 1984). The symptoms persisted for 3 days. 

Anti muscarinics Hyperthermia due to blockage of sweating mechanisms, decreased salivation and lacrimation, acute-angle-closure glaucoma in the elderly, urinary retention, constipation, blurred vision, delirium, and hallucinations... 

Ergot alkaloids Ischemia and gangrene fibroplasia of connective tissue uterine contractions, and hallucinations... 

The answers arc 488-d, 489-h. (Katzang, pp 108-112, 1020.) Atropine blocks muscarinic cholinergic transmission in the brain and in the autonomic nervous system. The result is dry mouth, thirst, dry and hot skin, tachycardia, urinary retention, ataxia, restlessness, excitement, and hallucinations, followed by stupor, delirium, respiratory depression, coma, and death. 

The typical antipsychotic drugs, which for 50 years have been the mainstay of treatment of schizophrenia, as well as of psychosis that occurs secondary to bipolar disorder and major depressive disorder, affect primarily the positive symptoms[10]. The behavioral symptoms, such as agitation or profound withdrawal, that accompany psychosis, respond to the antipsychotic drugs within a period of hours to days after the initiation of treatment. The cognitive aspects of psychosis, such as the delusions and hallucinations, however, tend to resolve more slowly. In fact, for many patients the hallucinations and delusions may persist but lose their emotional salience and intrusiveness. The positive symptoms tend to wax and wane over time, are exacerbated by stress, and generally become less prominent as the patient becomes older. 

Selegiline also increases the peak effects of L-dopa and can worsen preexisting dyskinesias or psychiatric symptoms such as delusions and hallucinations. Other adverse effects include insomnia, jitteriness. 

Withdrawal symptoms are tremor, tachycardia, diaphoresis, nausea, vomiting, elevated blood pressure, delirium, seizures, and hallucinations. 

Those experiencing intoxication with Henbane feel a pressure in the head, a sensation as if someone were closing the eyelids by force sight becomes unclear, objects are distorted in shape, and the most unusual visual hallucinations are induced. Gustatory and olfactory hallucinations frequently accompany the intoxication. Eventually sleep, disturbed by dreams and hallucinations, ends the inebriation. 

Jacobs, B. (1978) Dreams and hallucinations A common neurochemical mechanism mediating their phenomenological similarities. Neurosci. Biobehav. Rev., 2 59-69. 

Memantine is approved for treatment of moderate to severe Alzheimer s disease. It is an antagonist at glutamatergic NMDA-receptors. Memantine is well tolerated and has a small beneficial effect at six months in moderate to severe AD (McShane et al. 2006). For patients with dementia one has to be careful wit all kind of medications that may affect the central nervous system. Delirium and hallucinations are common adverse effects in patients with dementia. Agitation may be due to delirium and external causes should be ruled out before adding another psychoactive drug. Sleep disturbance is common in demented elderly patients. Sleep deprivation may in a patient with dementia induce delirium. Nonpharmacological treatment for delirium or hallucinations should be considered first. 

Delirium and hallucinations are common adverse effects in patients with dementia... 

Bassiony MM and Lyketsos CG (2003) Delusions and hallucinations in Alzheimer s disease review of the brain decade. Psychosomatics 44 (5) 388M01... 

Although GHB is primarily used for recreational purposes, cases of addiction to GHB have been reported. Some GHB users go on binges during which they take GHB around the clock (every 2-4 hours) for a few days. As the user takes additional doses, he or she develops tolerance to the effects of the drug (GHB becomes less effective with subsequent doses, so the user takes even more). Eventually, the binge GHB user exhibits signs of withdrawal, such as anxiety, insomnia, delirium and hallucinations, muscle cramping and tremors, and tachycardia (abnormally fast heart rate). 

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