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--- iatrogenesis [2023/01/11 15:49] – andrewtaustin
+++ iatrogenesis [2024/04/24 06:51] (current) – [Examples of Iatrogenesis from Psychiatric Medications] tom
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+{{tag>Related}}
 =====Iatrogenesis=====
 Iatrogenic[(Iatrogenesis>Iatrogenesis[[https://en.wikipedia.org/wiki/Iatrogenesis|Wikipedia]])] health conditions refer to harm or negative effects on a patient's health that are caused by medical treatment or interventions. These types of health conditions can range from minor side effects of medication to serious complications and even death. The process of creating these conditions is referred to as iatrogenesis.
-There are several ways in which iatrogenic health conditions can occur. One common way is through the use of medications. While medications can be essential for treating and managing various health conditions, they can also have unintended side effects. For example, a patient may experience nausea, dizziness, or allergic reactions when taking certain medications. In more serious cases, medications can cause more severe side effects such as organ damage or even death.
+There are several ways in which iatrogenic health conditions can occur. One common way is through the use of medications. While medications can be essential for treating and managing various health conditions, they can also have unintended side effects. For example, a patient may experience nausea, dizziness, or allergic reactions when taking certain medications. In more serious cases, medications can cause more severe side effects such as organ damage or even death. A current example is the use of Midazolam during the C crisis in the UK.
 Another way in which iatrogenic health conditions can occur is through medical procedures and surgeries. While these interventions can be necessary for improving a patient's health, they also carry risks and potential complications. For example, a patient may experience bleeding, infection, or nerve damage after surgery. In some cases, the procedure may not be successful and the patient's health may even deteriorate as a result.
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-  * **Nosocomial infections:** These are infections that patients acquire while receiving treatment in a healthcare facility, such as a hospital or nursing home. Nosocomial infections can occur due to a variety of factors, including poor hand hygiene, contaminated surfaces, or the use of contaminated medical equipment.[(Nosocomial>Hospital-acquired infection[[https://en.wikipedia.org/wiki/Hospital-acquired_infection|Wikipedia]])]
+  * **Nosocomial infections:** These are infections that patients acquire while receiving treatment in a healthcare facility, such as a hospital or nursing home. Nosocomial infections can occur due to a variety of factors, including poor hand hygiene, contaminated surfaces, or the use of contaminated medical equipment.[(Nosocomial>Hospital-acquired infection[[https://en.wikipedia.org/wiki/Hospital-acquired_infection|Wikipedia]])] [(Cov>14,000 people died with Covid after catching it in hospital [[https://www.mirror.co.uk/news/uk-news/we-need-better-over-14000-28046576|Mirror UK]])]{{ :covid_wales.jpg?200 |}}
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 It's important to note that while these are some common examples of iatrogenic health problems, this list is not exhaustive and there are many other types of iatrogenic health problems that can occur.
-====Examples of Iatrogenesis from Psychiatric Medications=====
+===== Assigning psychiatric diagnoses has negative consequences =====
+In the developed world, the diagnosis of mental illness is widespread among young adults - e.g., according to the study „Jugend in Deutschland 2024“ for Germany 11% of the 14-29 year old are in treatment[(JugendinDeutschland2024>Jugend in Deutschland 2024[[https://twitter.com/BentFreiwald/status/1782739548885463477|Bent Freiwald Twitter]])]. The paper "The Effects of Diagnosing a Young Adult with a Mental Illness: Evidence from Randomly Assigned Doctors"[( :harvard:Andres2023>>
+authors   : Bos, Marieke and Hertzberg, Andrew and Liberman, Andres
+title     : The Effects of Diagnosing a Young Adult with a Mental Illness: Evidence from Randomly Assigned Doctors
+publisher : Swedish House of Finance Research Paper No. 23-11
+published : September 15, 2023
+url       : http://dx.doi.org/10.2139/ssrn.4573307
+)] about the long-term causal effects of being diagnosed during young adulthood for those at the margin of diagnosis finds that, for people at the margin, a mental illness diagnosis increases the future likelihood of internal death, hospital admittance, being sick from work, and unemployment while also lowering expected income and the propensity to be married or have children. Diagnosis increases the use of psychiatric medication in the 36 months right after diagnosis. A possible interpretation offered for the results is that the amount and type of treatment used for marginal diagnosis may be inadequate, or inappropriate.
+=====Examples of Iatrogenesis from Psychiatric Medications=====
+==== Oculogyric Crisis ====
+Oculogyric crisis (OGC) is a type of movement disorder that is characterized by sustained or intermittent involuntary upward deviation of the eyes. It is also called a "dystonic storm" and is considered a subtype of dystonia. OGC is a relatively rare complication of antipsychotic medication use, although it is more common with some specific medications such as fluphenazine and haloperidol, also OGC has been observed in some cases with other psychotropics such as antidepressants, Lithium, and phenothiazines.
+Symptoms of an oculogyric crisis can include:
+  * Sustained upward deviation of the eyes
+  * Inability to move the eyes downward
+  * Difficulty with eye closure
+  * Blurred vision
+  * Light sensitivity
+  * Headache
+OGC can be distressing and disorienting for the person and can make it difficult for them to read, watch television, or even have a conversation. The episode of OGC can last from several minutes to several hours and can be relieved by treatment with anticholinergic drugs such as benztropine, diphenhydramine, or procyclidine. In some cases, it can also be relieved by decreasing the dose of the medication or stopping the medication.
+It's important for healthcare professionals to be aware of the potential for OGC when prescribing antipsychotic medications, and to monitor for symptoms. If OGC is suspected, the medication should be adjusted or discontinued and treatment should be started immediately.
+==== Dystonia ====
+Iatrogenic dystonia is a type of movement disorder that is caused by certain medications, particularly neuroleptics and other psychotropics. It is a form of dystonia that is characterized by muscle spasms, cramps, and contractions that cause abnormal postures and movements.
+Symptoms of iatrogenic dystonia can include:
+  * Sustained muscle contractions that cause abnormal postures or movements
+  * Spasms, cramps, and tremors in the face, tongue, neck, or other parts of the body
+  * Difficulty with speaking or swallowing
+  * Difficulty with eye movement
+  * Muscle stiffness or rigidity
+  * Fatigue
+Iatrogenic dystonia can range from mild to severe, and the symptoms can vary widely from person to person. It can develop within days or weeks of starting the medication or after several months or years of treatment.
+The most common medications associated with causing iatrogenic dystonia are neuroleptics, but it also can be caused by other drugs such as antidepressants and lithium.
+Treatment typically includes decreasing the dose of the medication, changing the medication, or stopping the medication. Additionally, anticholinergic drugs, such as benztropine, diphenhydramine, or procyclidine can be used to help relieve the symptoms. In some cases, physical therapy may also be beneficial to help manage the symptoms.
 ==== Tardive Dyskinesia ====
 Tardive dyskinesia is a neurological disorder characterized by repetitive, involuntary movements of the face, tongue, and other parts of the body. The exact cause of tardive dyskinesia is not well understood, but it is believed to be related to the long-term use of certain medications, particularly antipsychotics.
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 It is important for healthcare professionals to be aware of the potential for serotonin syndrome when prescribing medications that affect serotonin levels, and to monitor for symptoms when patients are taking multiple medications that may interact with each other. If serotonin syndrome is suspected, the medication should be discontinued and treatment should be started immediately. With prompt recognition and management, most people make a full recovery.
+==== Other Iatrogenic Conditions from Psychiatric Medications ====
+There are several other iatrogenic conditions that can be caused by psychiatric drugs, including:
+  * **Weight gain and metabolic changes:** Some antipsychotics, antidepressants and mood stabilizers can cause weight gain and changes in blood sugar and cholesterol levels, which can increase the risk of obesity, diabetes and cardiovascular disease.
+  * **Sexual dysfunction:** Some antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) can cause sexual dysfunction, such as difficulty achieving or maintaining an erection, difficulty with orgasm and decreased libido.
+  * **Gastrointestinal problems:** Some antidepressants, antipsychotics and mood stabilizers can cause gastrointestinal side effects, such as nausea, diarrhea and constipation.
+  * **Sedation and drowsiness:** Some antipsychotics, antidepressants and mood stabilizers can cause sedation and drowsiness, which can impair cognitive and motor function and increase the risk of accidents.
+  * **Hormonal imbalances:** Some antidepressants can cause hormonal imbalances, including changes in thyroid function and prolactin levels, which can affect metabolism, mood, and other bodily functions.