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Acute delirium induced by metoprolol
Alexander A Fisher1, Michael Davis, Ian Jeffery
1Department of Geriatric Medicine, The Canberra Hospital, The Canberra Clinical School of the University of Sydney, Canberra, Australia.
Cardiovascular Drugs and Therapy
|July 2, 2002
Summary
Metoprolol, a common beta-blocker, can rarely cause delirium, particularly in older adults. This adverse drug reaction is reversible upon discontinuation of metoprolol.
Area of Science:
- Pharmacology
- Neuroscience
- Geriatrics
Background:
- Metoprolol is a widely prescribed beta-blocker for cardiovascular conditions.
- Delirium is a serious neuropsychiatric condition characterized by acute confusion and cognitive impairment.
- Elderly patients are often more susceptible to adverse drug reactions.
Observation:
- A case of metoprolol-induced delirium in an 89-year-old man is presented.
- Analysis of 24 cases revealed delirium onset within a week of metoprolol initiation in 58% of patients.
- Common symptoms included confusion, disorientation, and agitation, with some experiencing hallucinations and delusions.
Findings:
- Delirium associated with metoprolol use is a rare but significant adverse effect.
- The majority of affected patients were over 60 years old.
- Other reported symptoms included bradycardia, hypotension, and fatigue.
Implications:
- Healthcare providers should consider metoprolol as a potential cause of delirium, especially in elderly patients.
- Early recognition and discontinuation of metoprolol can lead to rapid resolution of delirium.
- Further research into the mechanisms of metoprolol-induced delirium is warranted.