Drug-induced confusional states: the usual suspects?
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.


CONCLUSIONS
The data suggest that diuretics by way of causing hyponatraemia are as relevant a cause of ACS as dopaminergic or anticholinergic substances.
Department of Neurology, Verbundkrankenhaus Bernkastel-Wittlich, Koblenzer Str. 91, D-54516, Wittlich, Germany. a.hufschmidt@t-online.de
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Hufschmidt
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Shabarin
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Zimmer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects; D000978:Antiparkinson Agents / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000009:adverse effects; D003221:Confusion / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D003704:Dementia / Q000150:complications / Q000175:diagnosis; D004232:Diuretics / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000928:Antidepressive Agents; D000978:Antiparkinson Agents; D018680:Cholinergic Antagonists; D004232:Diuretics