Drugs that May Cause Delirium or Problem Behaviors Drugs that May Cause Delirium or Problem Behaviors This reference card lists common and especially problemac drugs that may Ancholinergics—all drugs on this side of the card. May impair cognion cause delirium or contribute to problem behaviors in people with demena. and cause psychosis. Drugs available over‐the‐counter marked with * This does not always mean the drugs should not be used, and not all such drugs are listed. If a paent develops delirium or has new problem Tricyclic Andepressants Bladder Anspasmodics behaviors, a careful review of all medicaons is recommended. Amitriptyline – Elavil Darifenacin – Enablex Be especially mindful of new medicaons. Clomipramine – Anafranil Flavoxate – Urispas Desipramine – Norpramin Anconvulsants Psychiatric Oxybutynin – Ditropan Doxepin – Sinequan Solifenacin – VESIcare All can cause delirium, e.g. All psychiatric medicaons should be Imipramine – Tofranil Tolterodine – Detrol Carbamazepine – Tegretol reviewed as possible causes, as Nortriptyline – Aventyl, Pamelor Gabapenn – Neuronn effects are unpredictable. Trospium – Sanctura Anhistamines / Allergy / Leveracetam – Keppra Notable offenders include: Insomnia / Sleep Valproic acid – Depakote Benzodiazepines e.g. Cough & Cold Medicines *Diphenhydramine – Sominex, ‐Alprazolam – Xanax *Azelasne – Astepro Pain Tylenol‐PM, others ‐Clonazepam – Klonopin *Brompheniramine – Bromax, All opiates can cause delirium if dose *Doxylamine – Unisom, Medi‐Sleep ‐Lorazepam – Avan Bromfed, Lodrane is too high or increased too quickly. Smulants e.g. Carbinoxamine – Rondec Stomach and GI Tract Codiene – Empirin, many others ‐Methylphenidate – Ritalin *Chlorpheniramine – Chlor‐Trimeton Fentanyl – Duragesic Ulcer and Reflux: Hypnocs (Sleep Medicaons ) e.g. *Clemasne – Tavist Hydrocodone – Lortab *Cimedine – Tagamet ‐Eszopiclone – Lunesta Cyproheptadine – Periacn Hydromorphone – Palladone, Glycopyrrolate – Robinul ‐Zaleplon – Sonata *Dexbrompheniramine –Drixoral *Ranidine – Zantac Dilaudid ‐Zolpidem – Ambien Dexchlorpheniramine – Polaramine Meperidine – Demerol Tricyclic Andepressants e.g. *Diphenhydramine – Benadryl GI Anspasmodics: Morphine – MS Conn, MS IR ‐Amitriptyline – Elavil Hydroxyzine – Atarax, Vistaril Atropine – Sal‐Tropine, Atreza Oxycodone – OxyConn ‐Doxepin – Silenor, Sinequan Olopatadine – Pataday, Patanol Belladonna Alkaloids – Donnatal, Tramadol – Ultram ‐Nortriptyline – Pamelor Promethazine – Phenergan Bellamine S, Bel‐Tabs, B&O Triprolidine – Triacin‐C supprees Parkinson’s/Restless Legs Anbiocs/Anvirals Clidinium – Librax Most Parkinson’s disease Difficult to disnguish drug effects Dicyclomine – Bentyl Moon Sickness / Dizziness / medicaons can cause psychosis. from effects of infecon. Others may Hyoscyamine – Levsin, Anaspaz, Amantadine – Symadine, Symmetrel contribute as well. Nausea Cytospaz Bromocripne – Parlodel Anviral *Dimenhydrinate – Dramamine Methscopolamine – Pamine, Pamine Levodopa – Sinemet , Stalevo ‐Acyclovir – Zovirax *Meclizine – Anvert, Forte Pramipexole – Mirapex ‐Valacyclovir – Valtrex Dramamine less drowsy Propantheline – Pro‐Banthine Rasagiline – Azilect Fluoroquinolones e.g. Promethazine – Phenergan Ancholinergic Anpsychocs Ropinrole – Requip ‐Levofloxacin – Levaquin *Scopolamine – Scopace, Transderm Rogone – Neupro ‐Ciprofloxacin – Cipro ‐Scop, Maldemar Chlorpromazine – Thorazine Selegiline – Eldepril, Emsam, Zelapar Metronidazole – Flagyl Trimethobenzamide – Tigan Clozapine – Clozaril Vancomycin – Vancocin Loxapine – Loxitane Steroids Movement Disorders Olanzapine – Zyprexa Cardiac Medicaons Corcosteroids e.g. Benztropine – Cogenn Pimozide – Orap ‐Prednisone – Deltasone, etc. Anarrhythmics Trihexyphenidyl – Artane Queapine – Seroquel Testosterone – Androgel, etc. Digoxin – Digitek, Lanoxin Thioridazine – Mellaril .