Nightmares vomiting

Toxic effects of propranolol are related to its blocking P-adrenoceptor blocking actions. They include cardiac failure, hypotension, hypoglycemia, and bronchospasm. Propranolol is lipophilic and crosses the blood—brain barrier. Complaints of fatigue, lethargy, mental depression, nightmares, hallucinations, and insomnia have been reported. GI side effects include nausea, vomiting, diarrhea, and constipation (1,2). 

Signs of intoxication are (1) cardiac arrhythmias, which under certain circumstances are life-threatening, e.g., sinus bradycardia, AV-block, ventricular extrasystoles, ventricular fibrillation (ECG) (2) CNS disturbances — altered color vision (xanthopsia), agitation, confusion, nightmares, hallucinations (3) gastrointestinal — anorexia, nausea, vomiting, diarrhea (4) renal — loss of electrolytes and water, which must be differentiated from mobilization of accumulated edema fluid that occurs with therapeutic dosage. 

Discontinuation of treatment Symptoms associated with discontinuation of duloxetine and other SSRIs and SNRIs have been reported. Monitor patients for symptoms including dizziness, nausea, headache, paresthesia, vomiting, irritability, and nightmares when discontinuing treatment. 

Adverse reactions include the following anorexia, apprehension, body/joint pain, chest pains, confusion, confusional states/memory impairment, congestion, constipation, coordination disorders, cramps/pain, depression, diarrhea, dreaming/nightmares, dry mouth, dysesthesia, euphoria, Gl pain, GU complaints, headache, heartburn, insomnia, irritability, lack of concentration, nausea, nervousness, palpitations, paresthesia, relaxed feeling, restlessness, tachycardia, taste alterations, tinnitus, tiredness, tremor, vomiting, weakness. 

The most common side effect of pentazocine is sedation resulting from an interaction with the K-receptor. Also observed are sweating, dizziness, psychotomimetic effects, anxiety, nightmares, and headache. Nausea and vomiting are less frequent than with morphine. Respiratory depression and increased heart rate, body temperature, and blood pressure accompany overdose. Naloxone is effective in reducing the respiratory depression but requires the use of higher doses than for morphine overdose. 

The most common early manifestations of digoxin toxicity are G1 disturbances (anorexia, nausea, vomiting) and neurologic abnormalities (fatigue, headache, depression, weakness, drowsiness, confusion, nightmares). 

Abrupt withdrawal after prolonged therapy may produce effects i ncl udi ng markedly increased dreaming, nightmares or insomnia, tremor, sweating, vomiting, hallucinations, delirium, seizures, and status epilepticus. 

Burning in the stomach, nausea, vomiting, diarrhea, dry mouth, nosebleed, stuffy nose, dizziness, headache, nervousness, nightmares, drowsiness, muscle aches, weight gain, redness of the eyes Rare... 

Agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, abnormality in thinking, hypoventilation, apnea, bradycardia, hypotension, syncope, nausea, vomiting, constipation, headache Rare... 

The most common side effects are Raynaud s phenomenon with cold or even cyanotic distal extremities and digits, tiredness or weakness, bradycardia, and sexual impotence. Less common side effects are depression and dysphoria, bronchoconstriction, congestive heart failure, hallucinations, hypotension, vomiting or nausea, diarrhea, insomnia and nightmares, dizziness, and hypoglycemia. When due attention is paid to contraindications and the treatment is carefully monitored, the side effects of beta-blocker treatment are generally mild. 

Adverse effects include diarrhoea, nausea, vomiting, vertigo, dizziness, headache, drowsiness, nightmares, asthenia, memory disturbances, depression, confusion, diplopia, tremor and ataxia. 

Sympathomimetic drug overdose. Some overdose symptoms are similar to those experienced during withdrawal. These include cramps, nightmares, nausea, and trembling. Vomiting will be more intense. The person may be dizzy and blood pressure may drop or rise. Respiration (breathing) is rapid, and the person may faint. 

Finn, an anesthetic cocktail used to lure sailors to the Orient in the 1800s. It has a rapid onset, short duration, and few cardiovascular or respiratory effects. Its side effects include an unpleasant taste, gastric irritation, nausea, vomiting, lightheadedness, and nightmares. It has a low margin of safety. 

Maxmen and Ward (1995) provided an extensive list of tricyclic antidepressant withdrawal symptoms. One group of withdrawal symptoms includes a flulike syndrome without fever anorexia, nausea, vomiting, diarrhea, queasy stomach, and cramps. A second group involves sleep disturbances insomnia, hypersomnia, excessive dreaming, and nightmares. A third group includes mania and hypomania. Maxmen and Ward pointed out that these symptoms can also be experienced between doses as the blood level drops. 

A 22-year-old woman gradually increased her dose of nefazodone to 400 mg/day over 3 weeks (16). One week later she abruptly discontinued treatment. About 48 hours later she began to have nausea, vomiting, fatigue, headache, myalgia, restlessness, dizziness, nightmares, emotional lability, and anxiety. These symptoms continued unabated for a further 48 hours, after which they remitted a few hours after nefazodone was restarted. 

Hallucinations have been described after the use of morphine in various dosage forms in one series, patients experienced adequate pain relief and no further hallucinations or nightmares when changed to oxycodone (540). Delusions and hallucinations have been reported in a patient who was also taking dosulepin (541). Restlessness, vomiting, and disorientation were described in two male patients over 60 years of age taking modified-release morphine for relief of pain in advanced cancer (542). 

---