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Early psychosis for the non-specialist doctor

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j4578 (Published 08 November 2017) Cite this as: BMJ 2017;357:j4578
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Re: Early psychosis for the non-specialist doctor, Response by authors to Dr Price on 22nd November 2017

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.

Dr Saqib Latif & Dr Musa Sami

Competing interests: No competing interests

29 November 2017
Saqib Latif
Consultant child and adolescent psychiatrist
Sami, Musa
Kent and Medway Children & Young People Services

Re: Early psychosis for the non-specialist doctor

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.

Competing interests: No competing interests

22 November 2017
Elizabeth H Price
Retired medical practitioner
retired
London
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