Seizure psychotic symptoms with

Benzodiazepines have a low abuse potential when they are properly prescribed and their use is supervised (American Psychiatric Association 1990). However, physical dependence often occurs when benzodiazepines are taken at higher-than-usual doses or for prolonged periods. If benzodiazepines are discontinued precipitously, withdrawal effects (including hyperpyrexia, seizures, psychosis, and even death) may occur. Signs and symptoms of withdrawal may include tachycardia, increased blood pressure, muscle cramps, anxiety, insomnia, panic attacks, impairment of memory and concentration, perceptual disturbances, and delirium. In addition, withdrawal-related derealization, hallucinations, and other psychotic symptoms have been reported. These withdrawal symptoms may begin as early as the day after discontinuation of the benzodiazepine, and they may continue for weeks to months. Evidence indicates that withdrawal reactions associated with shorter-half-life benzodiazepines peak more rapidly and more intensely. 

Blood pressure and heart rate should be monitored at each visit during the dose titration phase to permit early detection of adverse effects. To minimize the risk of development of movement disorders or psychotic symptoms, psychostimulants should be used cautiously in any patient with a history of tics or psychotic symptoms, or with a family history of Tourette s syndrome or schizophrenia. Nevertheless, studies have shown that psychostimulants are effective in treating ADHD in patients with co-morbid Tourette s syndrome and that they do not exacerbate tics in the majority of such patients ( 88, 89). Furthermore, no evidence indicates that psychostimulants can lower the seizure threshold or cause seizures. 

An overdose with an MAOI can produce a variety of effects including autonomic instability, hyperadrenergic symptoms, psychotic symptoms, confusion, delirium, fever, and seizures. Management of MAOI overdoses usually involves cardiac monitoring, vital support, and lavage. 

In a 28-year-old woman with psychotic symptoms resistant to monotherapy with clozapine or ziprasidone, the combination produced marked improvement in both positive and negative symptoms along with a reduction in adverse effects body weight fell, blood pressure, pulse, and the electrocardiogram remained normal, and valproic acid, which had been introduced for epileptic seizures during clozapine monotherapy, was successfully withdrawn (23). 

Information from double-blind studies of psychosis as an adverse event is relatively scarce. A double-blind, randomized, add-on, placebo-controlled trial with carbamazepine showed that there was no increase in chronic psychotic symptoms in patients with suspected temporal lobe seizures (48). 

Overdose with phencyclidine is dangerous. The basic principles of treatment are to maintain ventilation and to control seizures, blood pressure, and hyperthermia. Phencyclidine is secreted into the stomach, so removal of the drug may be hastened by activated charcoal or continual nasogastric suction. Phencyclidine is a weak base, and its renal elimination may be accelerated by urinary acidification. Treatment with antipsychotic drugs may be appropriate if psychotic symptoms follow the acute intoxication. The answer is (E). 

Urinary tract Urinary system adverse reactions, especially enuresis, have been associated with clozapine [SED-15, 832] with an estimated incidence greater than 6%. The mechanisms include overflow incontinence after urinary retention due to the anti-muscarinic action of clozapine or a cholinomimetic activity, and reduced internal urethral sphincter tone caused by aj adrenoceptor blockade enuresis has also been attributed to a non-specific action of clozapine such as excessive sedation, lowering of the seizure threshold, and constipation exacerbating urinary retention and over-fiow. Secondary enuresis in a 21-year man with schizophrenia settled with resolution of his psychotic symptoms but later remerged after starting clozapine [SS ]. 

Neurological symptoms, which tend to appear in the first week of therapy, consist of dizziness, confusion, irritability, psychotic behavioral changes, and even suicidal ideation. Cycloserine is contraindicated in patients with underlying psychiatric and seizure disorders. Other side effects include occasional peripheral neuropathy and low magnesium levels. 

A total of 136 cases of self-poisoning with diphenhydramine (with suicidal intent) have been evaluated. The most common symptom was impaired consciousness, followed by psychotic behavior resembling catatonic stupor. Other symptoms included hallucinations, mydriasis, tachycardia, and less often diplopia, respiratory insufficiency, and seizures (SEDA-13, 132). 

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