Table 5

Psychiatric side-effects of cardiovascular agents

AgentSide-effects
1. See text
Calcium-channel blockers
Diltiazem, amlodipine, felodipine, nicardipine, verapamil, bepridil, flunarizine, etc.Lethargy, extrapyramidal (akathisia), dysphoria, mania, psychosis, delirium
Adrenergic α2-agonists
α-methyldopa, α-methyl-p-tyrosineSomnolence, extrapyramidal, sleep disturbances, depression, psychosis, delirium
ClonidineDelirium, anxiety, agitation, hypomania, depression, psychosis, dementia
GuanabenzSedation, sleep disturbances, depression
GuanethidineSedation, depression
Catecholamine depleters
ReserpineDepression, suicidal ideation, sedation, psychosis, parkinsonism
Adrenergic antagonists
α1 selective antagonists: doxazosin, prazosin, terazosin, phentolamine, etc.Fatigue, insomnia, anxiety, sleep disturbances, libido and appetite disturbances, delirium
β-antagonists (β-blockers): actebutol, atenolol, propranolol, nadolol, pindolol, etc.Fatigue, sedation, sleep disturbances, depression1, cognitive impairment, hallucinations, psychosis, delirium
Angiotensin-converting enzyme (ACE) inhibitors
Benazapril, captopril, enalapril, fosinopril, etc.Fatigue, increased arousal and psychomotor activity, depression, mania, hallucinations, delirium
Diuretics
Potassium-sparing: amiloride, spironolactone, etc.Confusion, lethargy
Sulfonamides: acetazolamide, dichlorphenamideSedation, anxiety, depression, delirium
Thiazides: bendroflumethiazide, benzthiazide, chlorthalidone, etc.Sedation, anxiety, sleep disturbances
Nitrates and nitrites
Isosorbide dinitrate and mononitrate, nitroglycerin, etc.Anxiety, agitation, hypomania, psychosis, delirium
Anti-arrhythmic agents
Cardiac glycosides: digitoxin, digoxinSedation, apathy, depression, psychosis, visual changes (yellow visual images), delirium
MagnesiumLethargy, delirium
Local anaesthetics: lidocaine, mexiletine, moricizine, procainamide, etc.Lethargy, confusion, mood changes, psychosis, delirium
QuinidineCinchonism: including vertigo, altered colour perception, anxiety, confusion, delirium
DisopyramideSedation, mood changes, hallucinations, delirium
AmiodaroneSedation, sleep and mood disturbances, reduced libido