Confusional Episodes and Antidepressant Medication

The authors studied confusional reactions in patients receiving antidepressants. The incidence of these reactions was significant; they occurred in 13 percent of the total sample and 35 percent of those over 40 years of age. The relationship to age was significant, but sex, prior EEG abnormality, and dosage did not seem to markedly affect the occurrence of the confusional reactions. The clinical picture was that of a toxic psychosis, and the reactions responded favorably to a decrease in dosage of the antidepressant and/or the addition of a phenothiazine, along with increased attention to environmental factors.