Paradoxical reactions

Lorazepam (Ativan) 0.5-2 mg prior to chemotherapy Most common Sedation, amnesia Rare Respiratory depression, ataxia, blurred vision, hallucinations, paradoxical reactions (weeping, emotional reactions)... 

Perhaps the most hopeful sign of progress is the belated recognition of "paradoxical" reactions to the lipid-lowering diets that have been widely used for decades. For example, researchers at the South-Western Medical Center in Dallas repeatedly find "marked individual variations in response to the diet." In many persons these diets show little benefit, or increase LDL cholesterol, serum triglycerides, or... 

Paradoxical reactions Excitement, stimulation, and acute rage have occurred in psychiatric patients and hyperactive aggressive children. These reactions may be secondary to relief of anxiety and usually appear in the first 2 weeks of therapy. 

Contraindication are myasthenia gravis, chronic obstructive pulmonary disease and severe hepatic disease. Both in the elderly and in children paradoxical reactions were described. In the elderly the use of benzodiazepines is strongly correlated with falls and hip fractures. 

Excitement and other paradoxical reactions can occur in the elderly but also in young children. 

Thrombopoietin is a cytokine that selectively stimulates megakaryocytopoiesis. Thrombopoeitin is not used therapeutically. Theoretical uses include the procurement of platelets for donation and recovery of platelet counts after myelosuppressive chemotherapy. Flowever, a modified recombinant form caused paradoxical reactions, delaying the development of therapeutic thrombopoietin. 

Occasionally, patients with TBC may experience a temporary exacerbation of symptoms after beginning TBC treatment. This is known as a paradoxical reaction and has been noted to occur in HIV-1-infected patients with active TBC. These reactions are often related to the simultaneous administration of both antiretroviral and antituberculosis medica-... 

The diagnosis of a paradoxical reaction should be made only after a thorough evaluation has been made to exclude other etiologies. Some patients have required the use of corticosteroids (in addition to TBC treatment) to treat these reactions. 

Less common adverse effects include blurred vision, hallucinations, and paradoxical reactions consisting of excitement, stimulation, and hyperactivity. Also, a variety of gastrointestinal complaints occur, and blood dyscrasias have been reported, but these are rare. Benzodiazepine administration during pregnancy, delivery, or lactation has the potential to have adverse effects on the fetus or newborn. 

Behavioral problems such as anger, impaired memory, paradoxical reactions such as... 

Paradoxical reactions (agitation, restlessness, nightmares, insomnia, extrapyramidal symptoms, particularly fine hand tremor), laryngitis, seizures... 

Flushing, tachycardia, urine retention, constipation, paradoxical reaction (marked by restlessness and agitation), blurred vision... 

A paradoxical reaction, including restlessness, insomnia, euphoria, nervousness, and tremor, has been noted. 

Severe paradoxical reactions, marked by hallucinations, tremor, seizures, and toxic psychosis, may occur. 

Overdosage may vary from CNS depression, including sedation, apnea, hypotension, cardiovascular collapse, or death to severe paradoxical reaction, such as hallucinations, tremor, and seizures. 

Assess patients for paradoxical reaction, such as excitability, particularly during early therapy... 

Restlessness, emotional lability, paresthesia, flushing, paradoxical reaction Serious Reactions... 

The generally excellent tolerability of these preparations has contributed greatly to the widespread use of anxiolytics. The commonest side effects (Table 1.11) are tiredness and muscle relaxation and these usually can be avoided or attenuated by reducing the dose. Ataxia and paradoxical reactions such as irritability and increased agitation occasionally arise in the elderly but are rare in younger patients. Much attention has been focused on the negative effects of benzodiazepines on memory and other cognitive functions (see Chapter 7). 

Paradoxical reactions excitement, agitation, irritability, aggressiveness... 

Temazepam is rarely beneficial in patients with psychoses and may induce paradoxical reactions. It may exacerbate myasthenia gravis, Parkinson s disease, and chronic obstructive pulmonary disease. Temazepam may decrease plasma levels of haloperidol. 

This syndrome has similarities to the paradoxical reaction seen with barbiturates or BZDs, as well as epileptoid syndromes, including temporal lobe seizures and intermittent explosive disorder. Brain injury from trauma or encephalitis may also predispose some to an abnormally excessive response to even small amounts of alcohol. 

Rassiat E, Ragonnet D, Barriere E, Soupison A, Bernard P. Porphyrie aigue intermittente revelee par une reaction paradoxale a une benzodiazepine. [Acute intermittent porphyria revealed by a paradoxical reaction to a benzodiazepine.] Gastroenterol Clin Biol 2001 25(8-9) 832. 

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