Chantix-induced mental status changes in a young healthy female.

A 24-year-old Caucasian female was voluntarily admitted to an inpatient psyciatric unit after starting varenicline (Chantix). She reported feelings of paranoia, anxiety and suicidal ideation. She had no known history of psychiatric illness and was on no other medications prior to starting varenicline. This was her first attempt at smoking cessation, and she decided to use varenicline at the recommendation of her primary care provider and the South Dakota QuitLine program. We report this case to inform health care providers that the potential for psychiatric effects is possible, even in those individuals who do not have a history of psychiatric illnesses.

Case of acute psychosis from herbal supplements.

A recent study estimates that 15.2 percent of American adults use nonprescription dietary supplements for weight loss. Sale of ephedrine- and ephedrine-alkaloid-containing products was prohibited by the Food and Drug Administration in February 2004 after research demonstrated an increased risk of arrhythmia, mortality and hypertension following use of products containing these sympathomimetics. Subsequently, nutritional supplement manufacturers have turned to other products to promote weight loss. The following paper reports a case study of a 28-year-old woman with no prior psychiatric history who was hospitalized secondary to an acute psychotic episode. The patient reported starting several weight-loss and nutritional sports supplements approximately one week prior to admission. The relationship between the onset of psychosis and the initiation of the dietary supplements strongly suggests a correlation exists. Heightened consumer education regarding the contents of dietary supplements, along with their potential for causing adverse effects when used alone or in combination with other medications, is warranted. Patients who choose to take dietary supplements should be encouraged to inform their health care providers about the supplements they are taking.

Common CYP450 drug interactions with psychiatric medicines: A brief review for the primary care physician.

With thousands of drug interactions possible, it is next to impossible to remember them all. Additionally, with the common use of psychiatric medicines in primary care practice, drug interactions may occur without recognition. Some drug interactions are negligible while other drug interactions are quite significant. It is most important to remember the drug interactions that can have a clinical effect. Since approximately half of all medications prescribed today are affected by P450 enzymes, it is important to recognize some important interactions. This brief review will address the most common medications used to treat psychiatric illnesses today and their potential to cause CYP450-mediated drug interactions.