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Antimalarial Psychosis Revisited

Antimalarial Psychosis Revisited Abstract • Drug-induced psychosis resulted from the administration of quinacrine hydrochloride at a dosage of 100 mg twice daily for the treatment of discoid lupus. After two weeks of drug treatment, the patient exhibited symptoms similar to those seen in the manic phase of bipolar affective disorder. Although the incidence of antimalarial psychosis is unclear and perhaps small, we recommend close observation of patients for behavioral changes suggesting the development of antimalarial psychosis. Astute observation, leading to the early detection of behavioral changes, may help avert the development of a costly and disabling complication of drug therapy. (Arch Dermatol 1984;120:765-767) References 1. Dubois EL: Antimalarials in the management of discoid and systemic lupus erythematosus . Semin Arthritis Rheum 1978;8:33-51.Crossref 2. Gilman AG, Goodman LS, Gilman A (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics , ed 6. New York, Macmillan Publishing Co Inc, 1980, p 1078. 3. Ouslander JG: Drug therapy in the elderly . Ann Intern Med 1981;95:711-722.Crossref 4. Gaskill HS, Fitz-Hugh T: Toxic psychosis following Atabrine . Bull US Army Med Dept 1945;86:63-69. 5. Mustakallio KK, Puthonen T, Pikkanen TA: Chloroquine psychosis? Lancet 1962;2:1387-1388.Crossref 6. Dornhorst AC, Robinson BF: Chloroquine psychosis? Lancet 1963;1:108.Crossref 7. Rab SM: Two cases of chloroquine psychosis . Br Med J 1963;1:1275.Crossref 8. Sapp OL: Toxic psychosis due to quinacrine and chloroquine . JAMA 1964;187:373-375.Crossref 9. Brookes DB: Chloroquine psychosis . Br Med J 1966;1:983.Crossref 10. Kabir SMA: Chloroquine psychosis . Trans R Soc Trop Med Hyg 1969;63:549.Crossref 11. Bomb BS, Bedi HK, Bhatnagar LK: Chloroquine psychoses . Trans R Soc Trop Med Hyg 1975;69:523.Crossref 12. Lindenmayer J, Vargas P: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:162-164. 13. Rockwell DA: Psychiatric complications with chloroquine and quinacrine . Am J Psychiatry 1968;124:1257-1260. 14. Kingsbury AN: Psychoses in cases of malaria following exhibition of Atebrin . Lancet 1934;2:979-982.Crossref 15. Engel GL, Romano J, Ferris EB: Effect of quinacrine (atabrine) on the central nervous system . Arch Neurol 1947;58:337-350.Crossref 16. Lidz T, Kahn RL: Toxicity of quinacrine (Atabrine) for the central nervous system . Arch Neurol 1946;56:284-299.Crossref 17. David KL, Berger PA: Pharmacological investigations of the cholinergic imbalance hypothesis of movement disorders and psychosis . Biol Psychiatry 1978;13:23-49. 18. Wright CE, Sabine JC: Cholinesterases of human erythrocytes and plasma and their inhibition by antimalarial drugs . J Pharmacol Exp Ther 1948;91:230-239. 19. Malek-Ahmadi P: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:481. 20. Nasr S: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:481. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Antimalarial Psychosis Revisited

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1984.01650420075020
Publisher site
See Article on Publisher Site

Abstract

Abstract • Drug-induced psychosis resulted from the administration of quinacrine hydrochloride at a dosage of 100 mg twice daily for the treatment of discoid lupus. After two weeks of drug treatment, the patient exhibited symptoms similar to those seen in the manic phase of bipolar affective disorder. Although the incidence of antimalarial psychosis is unclear and perhaps small, we recommend close observation of patients for behavioral changes suggesting the development of antimalarial psychosis. Astute observation, leading to the early detection of behavioral changes, may help avert the development of a costly and disabling complication of drug therapy. (Arch Dermatol 1984;120:765-767) References 1. Dubois EL: Antimalarials in the management of discoid and systemic lupus erythematosus . Semin Arthritis Rheum 1978;8:33-51.Crossref 2. Gilman AG, Goodman LS, Gilman A (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics , ed 6. New York, Macmillan Publishing Co Inc, 1980, p 1078. 3. Ouslander JG: Drug therapy in the elderly . Ann Intern Med 1981;95:711-722.Crossref 4. Gaskill HS, Fitz-Hugh T: Toxic psychosis following Atabrine . Bull US Army Med Dept 1945;86:63-69. 5. Mustakallio KK, Puthonen T, Pikkanen TA: Chloroquine psychosis? Lancet 1962;2:1387-1388.Crossref 6. Dornhorst AC, Robinson BF: Chloroquine psychosis? Lancet 1963;1:108.Crossref 7. Rab SM: Two cases of chloroquine psychosis . Br Med J 1963;1:1275.Crossref 8. Sapp OL: Toxic psychosis due to quinacrine and chloroquine . JAMA 1964;187:373-375.Crossref 9. Brookes DB: Chloroquine psychosis . Br Med J 1966;1:983.Crossref 10. Kabir SMA: Chloroquine psychosis . Trans R Soc Trop Med Hyg 1969;63:549.Crossref 11. Bomb BS, Bedi HK, Bhatnagar LK: Chloroquine psychoses . Trans R Soc Trop Med Hyg 1975;69:523.Crossref 12. Lindenmayer J, Vargas P: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:162-164. 13. Rockwell DA: Psychiatric complications with chloroquine and quinacrine . Am J Psychiatry 1968;124:1257-1260. 14. Kingsbury AN: Psychoses in cases of malaria following exhibition of Atebrin . Lancet 1934;2:979-982.Crossref 15. Engel GL, Romano J, Ferris EB: Effect of quinacrine (atabrine) on the central nervous system . Arch Neurol 1947;58:337-350.Crossref 16. Lidz T, Kahn RL: Toxicity of quinacrine (Atabrine) for the central nervous system . Arch Neurol 1946;56:284-299.Crossref 17. David KL, Berger PA: Pharmacological investigations of the cholinergic imbalance hypothesis of movement disorders and psychosis . Biol Psychiatry 1978;13:23-49. 18. Wright CE, Sabine JC: Cholinesterases of human erythrocytes and plasma and their inhibition by antimalarial drugs . J Pharmacol Exp Ther 1948;91:230-239. 19. Malek-Ahmadi P: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:481. 20. Nasr S: Toxic psychosis following use of quinacrine . J Clin Psychiatry 1981;42:481.

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 1984

References