Metoprolol may reduce the effect of … Ideally, the patient should be in an environment where he or she can be observed and contained, if necessary, to avoid self-harm or harm to others.A medication retrial may be appropriate in certain situations, such as when the patient’s psychosis developed as a result of a high dosage or when the agent was used in combination with other psychotomimetics.Medication-induced psychosis has been associated with many nonpsychiatric medications.
Forster AJ, Murff HJ, Peterson JF, et al.
The effect is temporary, but for people with existing heart disease, an … He related his belief that since he 'had died and was brought back to life', he was now seeing people from the after-life. He was successfully resuscitated after approximately one to two minutes of ventricular fibrillation with electrical defibrillation.
She was unsure how long she had been on all of her medications but knew that she had been taking metoprolol for at least two years. While central nervous system adverse effects have been well-described with most beta-blockers (especially lipophilic agents such as propranolol), visual hallucinations have been only rarely described with metoprolol.Case 1 was an 84-year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night. Lisinopril is a generic medicine, and some of the brand name for it include Zestril and Prinivil. Metoprolol may be administered when heart failure has been controlled. Upon discontinuation of the metoprolol the visual disturbances resolved within several days. Her neurologic and psychiatric examinations were otherwise unremarkable except for a flat affect. Tijdschr Psychiatrie. Her physical examination and laboratory evaluation were unrevealing. She had no history of neurological or psychiatric illness nor were there any significant neuropsychiatric findings on physical examination. Part of One of metoprolol's effects is slowing the heart rate, and when people suddenly stop taking this medication, a rebound effect may occur, causing the resting heart rate to rise above normal limits 2 3. First, patients may not complain of visual disturbances because they fail to connect the symptoms with the drug, as in our second case. 1988, 223: 525-530.The author wishes to thank Raymond Smego Jr., MD, Associate Dean for Educational Development at The Commonwealth Medical College, for his review and critique of this manuscript.Department of Medicine, Pocono Medical Center, East Stroudsburg, PA, USAYou can also search for this author in The hallucinations resolved only after discontinuation of this medication.Case 2 was a 62-year-old Caucasian man with an inferior wall myocardial infarction complicated by cardiac arrest, who was successfully resuscitated and discharged from the hospital on metoprolol.
Recognition of visual hallucinations and other toxic CNS effects as potential complications of ACE inhibitor therapy will be especially important as these medications are increasingly extended to an aging population for the management of hypertension and heart failure with reduced ejection fraction.
Metoprolol, which has an intermediate degree of lipophilicity (a property known to enhance CNS drug penetration, as opposed to hydrophilicity, which limits brain entry), has rarely been reported to cause visual hallucinations despite its common usage [Under-reporting and under-recognition of hallucinations caused by metoprolol might be due to several factors. 2006, 47: 537-538.
Copies of the written consents are available for review by the Editor-in-Chief of this journal.Conant J, Engler R, Janowsky D, Maisel A, Gilpin E, LeWinter M: Central nervous system side effects of beta-adrenergic blocking agents with high and low lipid solubility.
Oral route (Tablet) Following abrupt cessation of therapy with certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction have been reported. Lisinopril can be used to treat high blood pressure, heart failure, and to … A thorough history is needed to help establish a temporal relationship.
Br Med J. Multiple reasons may lead to under-recognition and under-reporting of this adverse drug effect, by both patients and physicians alike. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (Goldner, J.A.
She did not have any hallucinations any other time of day or night. Metoprolol is a selective beta-blocker at dosages usually prescribed to lower blood pressure or relieve the symptoms of angina. She had no history of alcohol or illicit drug use. Warning. He would awake and see faceless figures sitting at the side of his bed; the figures would vanish as he became totally awake.
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