Second edition

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Table 5.2 Causes of delirium
Toxic delirium
Medications
Analgesics
Opioids (Crawford and Baskoff 1980; Eisendrath et al. 1987;
Morisy and Platt 1986; Steinberg et al. 1992)
Propoxyphene (Nomdedeu et al. 2001)
Tramadol (Kunig et al. 2006)
Anticholinergics
Diphenhydramine (Agostini et al. 2001)
Scopolamine (Minagar et al. 1999; Ziskind 1988)
Benztropine (De Smet et al. 1982)
Commonly prescribed
Baclofen (Lee et al. 1992)
Baclofen withdrawal (Leo and Bar 2005)
Metoclopramide (Fishbain and Rogers 1987)
Cyclobenzaprine (Engel and Chapron 1993)
Amantadine (Postma and Van Tilburg 1975)
Benzodiazepines (Marcantano et al. 1994)
Dextromethorphan (Lotrich et al. 2005)
Specific syndromes
Serotonin syndrome
Combination of serotoninergic medications (Bodner
et al. 1995)
Neuroleptic malignant syndrome
First-generation (Keck et al. 1987; Pope et al. 1986;
Rosebush and Stewart 1989) and second-generation
(Meterissian 1996, Miller et al. 1991; Sachdev et al. 1995)
antipsychotics
Discontinuation of dopaminergic agents (e.g., levodopa
[Sechi et al. 1984; Toru et al. 1981], amantadine
[Cunningham et al. 1991; Harsch 1987])
Dopaminergic medications
Levodopa (Friedman and Sienkiewicz 1991)
Bromocriptine (Serby et al. 1978)
Lergotrile (Serby et al. 1978)
Cardiac medications
Amiodarone (Anastasiou-Nana et al. 1986; Athwal
et al. 2003; Barry and Franklin 1999)
Digoxin (Eisendrath and Sweeney 1987; Shear and
Sacks 1978)
Quinidine (Qunitanilla 1957)
Antimetabolites
Tacrolimus (Buis et al. 2002)
Cyclosporine (Buis et al. 2002)
Antimicrobials
Acyclovir (Rashiq et al. 1993; Tomson et al. 1985)
Gancyclovir (Davis et al. 1990)
Vidarabine (Cullis and Cushing 1984)
Trimethoprim (Antonen et al. 1999)
Cefipime (Capparelli et al. 2005)
Ciprofloxacin (Altes et al. 1989)
Oflaxacin (Fennig and Mauas 1992)
Clarithromycin (Mermelstein 1997)
Metronidazole (Kusumi et al. 1980)
Ketoconazole (Fisch and Lahad 1989)
5.3 Delirium 177
Anti-epileptics
Valproic acid (Beversdorf et al. 1996)
Carbamazepine (Horvath et al. 2005)
Gabapentin (Zhang et al. 2005)
Antidepressants and mood stabilizers
Amitriptyline (Preskorn and Simpson 1982)
Imipramine (Goodwin 1983)
Bupropion (Ames et al. 1992)
Lithium (DePaulo et al. 1982; Kaplan et al. 2006; Simard
et al. 1989)
Valproic acid (Beversdorf et al. 1996)
Miscellaneous
Propranolol (Topliss and Bond 1977)
Verapamil (Jacobsen et al. 1987)
Interleukin 2 (Illowsky et al. 1996)
Disulfiram (Hotson and Langston 1976; Kirubakaran et al.
1983; Knee and Razani 1974; Laplane et al. 1992)
Gold (McCauley et al. 1977)
Aspirin (in overdose [Steele and Morton 1986])
Bismuth (Gordon et al. 1995; Jungreis and Shaumberg
1993; Molina et al. 1989; Supino-Viterbo et al. 1977)
Bromide (Curran 1938; Palatucci 1978)
Metrizamide (Elliot et al. 1984)
Intoxicants
Cocaine (Fischman et al. 1976)
Amphetamine (Hollister and Gillespie 1970)
Phencyclidine (Allen and Young 1978; Pearlson 1981)
Cannabis (Chopra and Smith 1974; Palsson et al. 1982)
Inhalants (Evans and Raistrick 1987)
Methanol (Bennett et al. 1953; Erlanson et al. 1965;
Wood and Buller 1904)
Metabolic delirium
Specific metabolic derangements
Uremic encephalopathy (Raskin and Fishman 1976;
Stenback and Haapanen 1967; Tyler 1968)
Hepatic encephalopathy (Fraser and Arieff 1985; Read
et al. 1961; Summerskill et al. 1956)
Respiratory failure (Austen et al. 1957; Bacchus 1958; Dulfano
and Ishikawa 1965; Westlake et al. 1955)
Obstructive sleep apnea (Lee 1998; Munoz et al. 1998; Whitney
and Gannon 1996)
Hyponatremia (Karp and Laureno 1993; Swanson and Iseri
1958; Welti 1956)
Hypernatremia (Jana and Romano-Jana 1973)
Hypoglycemia (Case records 1988a; Hart and Frier 1998;
Malouf and Brust 1985; Moersch and Kernohan 1938)
Hyperglycemia (Gomez Diaz et al. 1996; Khardori and
Soler 1984)
Hypocalcemia (Denko and Kaelbling 1962, Hossain 1970)
Hypercalcemia (Karpati and Frame 1964; Weizman et al.
1979)
Hypomagnesemia (Fishman 1965; Hall and Joffe 1973)
Hypermagnesemia (Clark and Bowen 1992)
Systemic effects of infection
Sepsis (Eidelman et al. 1996)
(continued)