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Psychiatric Side Effects of Nonpsychiatric Medications

The accredited CME learning activity based on this article is offered under the auspices of the CE department of the University of Toronto. Participating physicians are entitled to one (1) MAINPRO-M1 credit by completing this program, found online at www.geriatricsandaging.ca/cme

Kannayiram Alagiakrishnan, FRCP(C), Associate Professor, Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, AB.
Cheryl A. Wiens, PharmD, Associate Professor, Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, AB.

Numerous medications are capable of causing psychiatric side effects. Drug abuse or misuse, polypharmacy, or physiological changes due to aging may lead to these adverse effects. Drug-induced effects on mental health is a topic of considerable clinical importance and yet it is poorly recognized by health care professionals. This article is a review of psychiatric side effects of prescription and over-the-counter medications, problem recognition, and what can be done to manage and prevent these adverse events. Prevention of drug-induced psychiatric side effects can be aided by avoiding, where possible, medications that can cause these effects; evaluating renal and hepatic function on a regular basis; avoiding agents that can cross the blood-brain barrier; and conducting brief cognitive and behavioural assessments at baseline with follow up on a periodical basis.
Key words: psychiatric side effect, renal insufficiency, nonpsychiatric medications, adverse drug reactions, cognitive impairment.