Diltiazem mania with

A patient taking diltiazem developed the signs and symptoms of mania (114) and another developed mania with psychotic features (115). There have also been reports that nifedipine can cause agitation, tremor, belligerence, and depression (116), and that verapamil can cause toxic delirium (117). Nightmares and visual hallucinations have been associated with nifedipine (118). Depression has been reported as a possible adverse effect of nifedipine (119). 

Lithium is frequently combined with both traditional and atypical antipsychotics in euphoric acute mania with psychotic features. Case reports of neurotoxicity (e.g., delirium, cerebellar dysfunction, extrapyramidal symptoms, and severe tremors) have been reported in elderly patients receiving lithium and traditional antipsychotics. Combining lithium with calcium channel blockers is not recommended because of reports of neurotoxicity and severe bradycardia with verapamil and diltiazem. Acute neurotoxicity and delirium have been reported in patients receiving ECT with lithinm (even at reduced dosages) therefore lithium should be withdrawn and discontinued at least 2 days before ECT and should not be resumed until 2 to 3 days after the last treatment. 

Palat GK, Hooker EA, Movahed A. Secondary mania associated with diltiazem. Clin Cardiol 1984 7(11) 611—2. 

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See also in sourсe #XX -- [ ]

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