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Digitalis delirium: psychiatric considerations

M K Shear, M Sacks

    International Journal of Psychiatry in Medicine
    |January 1, 1977
    PubMed
    Summary
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    Digitalis toxicity can cause psychiatric issues, often overlooked in clinical settings. Psychiatrists should consider digitoxicity when patients present with mental abnormalities, as it can be a sign of a life-threatening condition.

    Area of Science:

    • Pharmacology
    • Psychiatry
    • Toxicology

    Background:

    • Digitalis is a common medication with potential for iatrogenic toxicity.
    • Digitoxicity-induced psychiatric symptoms are frequently misdiagnosed or overlooked.
    • Psychiatric patients may have increased susceptibility to digitalis toxicity.

    Purpose of the Study:

    • To highlight the psychiatric manifestations of digitalis toxicity.
    • To emphasize the importance of considering digitalis as a cause of mental abnormalities in psychiatric patients.
    • To alert clinicians to the potential for digitoxicity in psychiatric settings.

    Main Methods:

    • Case report of two patients presenting with psychiatric symptoms due to digitoxicity.
    • Review of literature on digitalis toxicity and its psychiatric sequelae.

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    Main Results:

    • Both patients exhibited psychiatric symptoms later attributed to digitalis toxicity.
    • Psychiatric signs can be the initial indicators of digitalis excess.
    • Erratic drug use, electrolyte imbalance, and autonomic tone can increase risk in psychiatric patients.

    Conclusions:

    • Psychiatric symptoms warrant consideration of digitalis toxicity.
    • Early recognition of digitoxicity is crucial for managing this potentially lethal condition.
    • Clinicians should maintain a high index of suspicion for digitalis toxicity in psychiatric patients.