Medications and Medical Conditions That Can Cause a
Change in Mental Status
 Some Medical Conditions and Medications Can Lead to a
Change In Mental Status - Overview
 Selected Medications That Could Lead to Mental Status
Changes
 Selected Medical Conditions That Could Lead to Mental
Status Changes
 Petit Mal Seizure
© 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation
Some medical conditions and medications can lead to a change in mental
status
This could cause non-adherence to the plan developed by the CPS caseworker
Sometimes people may not know they have a health condition
Older adults can be more susceptible to mental status changes caused by
medications or by a medical condition such as dehydration or an infection (like
pneumonia or a urinary tract infection)
Any medical condition that involves decreased oxygen delivery to the brain can
appear as drunken behavior
Certain medications, such as steroids, can lead to mental status changes as can
withdrawal from some drugs (medications and drugs of abuse) and from alcohol
Vitamin deficiencies can cause mental status changes (In the U.S., where we
have lots of food, vitamin deficiencies are often but not always seen in people
who don’t eat well, for instance alcoholics)
Toxins like lead and other heavy metals, pesticides, solvents, carbon monoxide,
drugs of abuse and medications can cause mental status changes
© 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation
Selected medications that could lead to mental status changes
Medication
Atarax/Vistaril (hydroxyzine)
L-Dopa and Sinemet
(levodopa + carbidopa)
Amantadine
H2 Blockers:
Tagamet (cimetidine),
Zantac (ranitidine),
Pepcid (famotidine),
Axid (nizatidine)
Benadryl (diphenhydramine)
Oral Hypoglycemics:
Uses
Anxiety, some allergic conditions, nausea
Parkinson’s disease
Parkinson’s disease, respiratory infections
caused by influenza A virus, fatigue in multiple
sclerosis
Gastroesophageal reflux disease (GERD), ulcer,
esophagitis
Allergic symptoms
Type 2 (Non Insulin-Dependent) Diabetes
Prandin (repaglinide)
Starlix (nateglinide)
Amaryl (glimepiride)
Glyburide
Glucotrol (glipizide)
Benzodiazepines:
Anxiety, insomnia
Valium (diazepam),
Klonopin (clonazepam),
Restoril (temazepam),
Dalmane (flurazepam),
Librium (chlordiazepoxide),
Serax (oxazepam),
Ativan (lorazepam),
Xanax (alprazolam),
Halcion (triazolam) and others
Anticholinergic
antidepressants:
Elavil (amitriptyline),
Tofranil (imipramine),
Sinequan (doxepin)
Other antidepressants:
Prozac (fluoxetine)
Narcotics (Opioid Analgesics)
especially meperidine
Beta Blockers:
Depression
Depression, bulimia nervosa, obsessivecompulsive disorder, premenstrual dysphoric
disorder, panic disorder
Pain
High Blood Pressure, heart conditions
Source: Chester Fox, MD; Document: Polypharmacy Audit Tool
© 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation
Selected medical conditions that could lead to mental status changes
(Please note these conditions have signs and symptoms in addition to those listed in the table.)
Medical condition
Low blood sugar in diabetics
(hypoglycemia)
Severely high blood sugar in
diabetics (severe hyperglycemia)
Stroke
Heart attack
Seizure disorder-post seizure
period
Absence (Petit Mal) seizures
Multiple sclerosis (MS)
Meningitis
HIV dementia
Hyperthyroidism
Hypothyroidism
Brain tumor
Parkinson disease
Systemic lupus erythematosus
Sodium imbalance (high or low)
Liver failure- psychiatric
symptoms
(may see in alcoholics)
Kidney failure- psychiatric
symptoms
Cushing syndrome
Possible mental status change
Apprehension, disorientation, confusion,
hallucinations and eventually stupor and coma
Fatigue, nausea, vomiting, thirst, frequent urination
and eventually disorientation and confusion
Confusion and difficulty with speaking, walking or
other motions
Nausea, vomiting, sweating, anxiety, delirium,
stupor
Delirium, memory problems, perceptual problems
e.g. hallucinations, fear, anxiety
Blank stare or brief lapse of attention mainly in
children, may be considered “daydreaming”
Highly variable; memory loss, euphoria and/or
depression, laughter or weeping suddenly for no
apparent reason, difficulty walking
Sudden onset of confusion, headaches, memory
impairment
Difficulty concentrating, subtle mood changes,
disorientation, lethargy and eventually delirium,
trouble walking and other motor incoordination
Anxiety, confusion, agitated depression, sweating,
fine tremor and even mania or psychosis
Depression, anxiety, poor memory and even
delirium and psychosis
50% can have psychiatric symptoms
Usually over 50; depression, anxiety, impaired
memory/concentration, fatigue, panic disorder,
tremor, slow movement, and later, hallucinations
and delusions
Depression, emotional lability, delirium and
psychosis
Especially in the elderly; sudden mental status
change
Mental changes come and go; restlessness, poor
handwriting, trouble sleeping, and later lethargy,
disorientation, mood swings, disinhibition and stupor
Fatigue, problems with concentration/memory,
depression, lethargy and even psychosis
Depression, impaired memory/concentration,
possibly psychotic symptoms
Source: http://www.emedicine.com/med/topic3447.htm#section~author_information
© 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation