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Drug-induced confusional states: the usual suspects?
A Hufschmidt1, V Shabarin, T Zimmer
1Department of Neurology, Verbundkrankenhaus Bernkastel-Wittlich, Koblenzer Str. 91, D-54516, Wittlich, Germany. a.hufschmidt@t-online.de
Background:
Acute confusional state (ACS) is a frequent reason for hospital admission. This study examines retrospectively the frequency by which individual drugs were found responsible for ACS.
Results:
Drug-induced ACS was found in 65 (18.8%) of 346 hospital admissions for acute confusion. The most frequent causative substances were dopaminergic drugs in Parkinsonian patients (24.2%), diuretics (15.1%), tricyclic or tetracyclic antidepressants (13.6%) and benzodiazepines (13.6%). Almost half of the patients were demented, and in one-third of these, dementia had not been diagnosed hitherto.
Conclusion:
The data suggest that diuretics by way of causing hyponatraemia are as relevant a cause of ACS as dopaminergic or anticholinergic substances.
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