Carbamazepine: Sedation, irritability, and depression at the start of treatment; on to psychosis.

Phenacemide: Emotional lability, agitation, and confusion in a few.

Phenobarbital: Normal blood levels (5 to 40 µg/ml) occasionally may produce irritability and mood disturbance, cognitive impairment, confusion, or a combination of these, whereas excessive dosage will produce sedation grading into ataxia and coma. Symptoms of withdrawal may occur if phenobarbital is stopped abruptly.

Phenytoin: Irritability, nystagmus, tremor, and ataxia often begin at 20 µg/ml and worsen as the dose climbs. Psychosis may occur.

Primidone: More than 50% of patients experience sedation, irritability, weakness, vertigo, or a combination of these on beginning the medication.

Salicylates: High doses can produce elation and euphoria grading into depression, confusion, and delirium.

Nonsteroidal anti-inflammatory drugs (NSAIDs): About 50% of patients experience sedation, headache, and dizziness. In high doses, a few will produce anxiety, disorientation, and confusion.

Exogenous thyroid: Excess can result in symptoms varying from restlessness and anxiety to a psychosis mimicking mania or acute schizophrenia. Inadequately treated patients may display symptoms of hypothyroidism [e.g., fatigue, depression, psychosis (myxedema madness)].

Adrenal corticosteroids (e.g., cortisone, dexamethasone, prednisone): In addition to physical complications, excessive or prolonged use can produce widely varying affective syndromes (e.g., euphoria and hypomania, fatigue, and depression) or degrees of a toxic psychosis or both. Steroid withdrawal can produce complaints of weakness and fatigue—suspect pseudotumor cerebri if coupled with headache, vomiting, and confusion.