Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia.
Psychiatr Danub. 2009 Dec;21(4):570-4.
Diagnostic recognition and distinguishing of psychotropic side effects which are phenomenological Identical/similar to symptoms and/or signs of psychiatric disorders undergoing psychotropic treatment, is an integral element within the general diagnostic procedure. Unrecognising and undistinguishing of psychotropic-induced side effects from psychopathological phenomena and/or physical signs which are, according to relevant classification criteria, standard parts of psychiatric disorders, most frequently can cause increase the dose of the psychotropic medication, assigning of the unwarranted diagnoses, and/or addition of unnecessary medications. Some of the most frequent side effects that can be caused by the diagnostic difficulties and/or misjudgements of the phenomenological recognition and differentiating side effects from psychiatric symptoms and signs are: drug-induced akathisia, intensive anticholinergic pharmacodynamic effects including delirium, neuroleptic induced Parkinsonism, paradoxically antidepressants-induced worsening or re-emerging depression, acute dystonia and tardive dyskinesia and others. In conclusion, differential diagnosis of these side effects requires careful evaluation based on clinical experience and knowledge.
诊断识别和区分精神药物副作用与正在接受精神药物治疗的精神障碍的症状和/或体征在现象学上是相同/相似的，这是一般诊断程序的一个组成部分。如果不能识别和区分精神药物引起的副作用与根据相关分类标准属于精神障碍标准部分的精神病理学现象和/或身体迹象，最常见的情况是会增加精神药物的剂量、赋予不必要的诊断、和/或添加不必要的药物。由于诊断困难和/或对精神症状和体征的现象学识别和区分副作用的错误判断，可能会导致一些最常见的副作用，如：药物引起的静坐不能、强烈的抗胆碱能药效学作用包括谵妄、抗精神病药引起的帕金森病、抗抑郁药引起的矛盾性恶化或复发抑郁、急性肌张力障碍和迟发性运动障碍等。总之，这些副作用的鉴别诊断需要基于临床经验和知识进行仔细评估。
