Iatrogenic Psychoses

Iatrogenic psychoses can cause disability, worsen previous disability, and render clinical management extraordinarily difficult. In certain cases, psychosis precedes more severe and overt toxicity, which can lead to encephalopathy or coma. This article offers an overview of iatrogenic (ie, treatment-induced) psychoses. "Pure" psychoses (ie, without confusion or mood disturbance) are emphasized. Shortcomings of available data are highlighted. The epidemiology, definition, diagnosis, differential diagnoses, risk factors, and course are discussed. Therapeutic measures include discontinuation or decreasing the dose of the suspected medication and the administration of neuroleptics, antimanics, and antidepressants. Other general principles of clinical management are given. A brief review of etiopathogenic mechanisms is offered and areas for future research are emphasized.