Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
We agree with Dr Price that psychotic symptoms can occur, and are sometimes exacerbated, with certain medications. Benzodiazepines withdrawal can mimic as psychotic symptoms, however, one should make a distinction between psychotic symptoms and psychotic disorders. Most of these states can be characterised by transient psychotic features, they would not often be diagnosed as psychotic disorder per se. We do agree, however, that for those presenting with psychotic symptoms a full medication history and consideration of withdrawal states should be considered.
Although medication induced psychotic symptoms were in one of the tables , there was no mention of drug combinations (including the benzodiazepines, even if just prescribed for sleeping). These psychotic effects may be exacerbated by caffeine and can also occur on withdrawal.