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Dementia-like symptoms have been found in some individuals who have been exposed to glucocorticoid medication, often dispensed in the form of asthma, arthritis, and anti-inflammatory steroid. [2] The term "steroid dementia" was coined by Varney et al. (1984) in reference to the effects of long-term glucocorticoid use in 1,500 patients. [3]
Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, [1] are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribing medications for adults 65 years and older in all except palliative settings.
The most common causes of drug induced acute confusion are dopaminergic drugs (used for the treatment of Parkinson's disease), diuretics, tricyclic, tetracyclic antidepressants and benzodiazepines or alcohol. The elderly, and especially those with pre-existing dementia, are most at risk for drug induced acute confusional states. [8]
The systems of the body most affected by chemotherapy drugs include visual and semantic memory, attention and motor coordination and executive functioning. [9] [10] These effects can impair a chemotherapy patient's ability to understand and make decisions regarding treatment, perform in school or employment and can reduce quality of life. [10]
Elderly people are also at a heightened risk for developing TD, [10] as are females and those with organic brain injuries or diabetes mellitus and those with the negative symptoms of schizophrenia. [25] TD is also more common in those that experience acute neurological side effects from antipsychotic drug treatment. [25]
Drug classes such as hypnotics, benzodiazepines, acetylcholinesterase inhibitors (AChIs), N-methyl D-aspartic acid antagonists (NMDA), selective serotonin reuptake inhibitors (SSRIs), and sedative antipsychotics have been used to treat sundowning, but their side effects limit their overall effectiveness in a risk versus benefit balance.
Treatment for withdrawal usually involves weaning over a 3- to 21-day period if the infusion lasted for more than a week. [134] Symptoms include tremors, agitation, sleeplessness, inconsolable crying, diarrhea and sweating. In total, over fifty withdrawal symptoms are listed in this review article.