illustration of a head splitting in two with green waves of pain radiating out

There are few drug side effects as unsettling as those that affect the brain. What makes them especially challenging is that prescribers may fail to mention them. As a result, many people are totally unprepared for their drugs to cause psychiatric side effects.

Watch Out for the White Rabbit!

Back in the 1960s, Grace Slick and the Jefferson Airplane had a big hit with their psychedelic song, “White Rabbit”:

“One pill makes you larger, and one pill makes you small.

“And the ones that Mother gives you don’t do anything at all.

“Go ask Alice, when she’s ten feet tall.”

Psychiatric Side Effects & Hallucinations:

Hallucinations are an especially troubling adverse drug reaction if a person has not been warned. We heard from a reader:

“I have taken tramadol for lower back pain for several years. Just in the past year I started having both auditory and visual hallucinations.

“I have seen a huge spider crawling across the ceiling a few times. I wake from naps on my recliner and everything in the room is bright green, once yellow. I saw an elderly woman with one missing eye, ghost-like, this week. I have heard loud banging sounds at night and what sounded like rats crawling around in the bedroom ceiling. I have heard my husband call my name when he hasn’t spoken.

“I have started talking in my sleep, too. I am planning to talk to my physician when I go for my annual checkup.”

Most people don’t expect their pain reliever to cause hallucinations. It seems even less likely that antibiotics would cause delirium. However, a study published last summer found that the antibiotic clarithromycin triggered neuropsychiatric symptoms in some people (JAMA Internal Medicine, June, 2016).  People taking clarithromycin (Biaxin) were four times more likely to have a problem such as delirium, cognitive difficulty, sleep problems, mood disorders or psychosis as when they were not taking the medication.

Fluoroquinolones and Psychiatric Side Effects:

Fluoroquinolone antibiotics such as ciprofloxacin (Cipro) or levofloxacin (Levaquin) can also cause hallucinations. A daughter told of her mother’s ordeal:

“My mother was hospitalized for a bladder infection. After the second dose of Levaquin she started hallucinating.

“We tried to get help for her and the nurses told us it was sundowner’s syndrome. I don’t believe it; my mother had no dementia before.

“We stayed with her through the night and refused to allow her to be given further treatment but she was never the same. A friend told me her father had the same hallucinations.”

People are not always warned that corticosteroids such as prednisone can also cause significant psychiatric reactions. Here is just one report:

“I was prescribed prednisone for inflammatory bowel disease. The first dose I took had me sweating. By day 3 I also had extreme anxiety, insomnia and intense mood swings. Soon I developed alarming paranoia, plus delusions and auditory hallucinations.

“I was hospitalized three times for treatment. At last I was treated as an inpatient for ten days. Prednisone ruined my life.”

Doctors must alert patients to possible psychiatric side effects brought on by medications. The adverse drug reactions may include anxiety, depression, irritability, confusion or hallucinations. Otherwise such side effects could have tragic consequences.

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  1. Chris

    I think the laws need to change noq. U til you hit the Corp where it hurts them they will never change. Time for more court cases individual or class acts. We need to get this into to all of us who are suffering but are told by doctors”o it’s nothing. If it were
    e serious you’d be dead by now. Imagine h
    hearing that?

  2. Anne
    Bakersfield, CA

    After having negative experiences from prescription drugs, my husband and I take no pills whatsoever and have been better for it. The body has a wonderful way of healing itself if given time, but cannot do its job if it is impaired with drugs. Back pain goes away on its own, usually.

  3. Dixie

    I took one capsule of Avelox, a fluoroquinolone, for sinus infection. Soon, I was sobbing hysterically, walking the floor. I’ve handled many situations, but not that one pill. Research showed the quinolones have many side effects. I also can not use preservatives, doctor said I had to. When I stopped the meds, he told me to go elsewhere.

  4. Suzie

    My mother always got confused when she had a bladder infection and then the meds seemed to make her worse. It was trial and error, and she began seeing people and when she got really confused, we had to sit with her thru the night in the hospital and once for about 3 nights her hallucinations were so bad. Turned out to be from the medication in her eye drops–the same as you take for motion sickness–scopolomine (not sure the spelling is right). But the same thing that’s in the patch one wears behind the ear for motion sickness.

    The doctor was looking over her records and found that this was in her eyedrops and when they stopped them and gave her some sedative, she began to ‘come around’ . Strange thing–she remembered a lot of what she’d seen! she was in her 90’s and very ‘with it’ otherwise.

  5. PattyPR

    DAND E,
    I think you probably have a case for malpractice.

    Sharon, talk to your doctor about getting off those drugs. If you are as scared as you say, that could be possibly compounded by the drugs themselves. If your current doctor won’t act to handle your issues in another manner, find a more interactive doctor that will. I will not use a doctor that basically throws prescriptions at me without taking into consideration that I tend to have side effects from most I take. It may take a few different tries, but every time I move I always find a medical doctor who is down to earth and easy to work with on finding a solution that fits me.

    It’s worth driving to another town for me. My primary care luckily is only 1 hour away. Most of my specialists are an hour away, but there are others much closer that are not as good. Your well-being and health is worth the added time spent.

  6. PattyPR

    I was given Valium (as a muscle relaxer) after major abdominal surgery along with a number of other drugs. I had an allergic reaction to the Valium, which included paranoia and hallucinations. I saw hand-drawn rats and mice (like line drawings) running along the baseboards off & on.

    I was too afraid of the doctors and nurses to tell them what I was seeing, like there would be bad consequences. I thought the staff were “out to get me”, and even asked one nurse if she was a Nazi after either waking from a dream or coming out of a hallucination having to do with being tortured by Nazis.

    The symptoms went on for weeks before my husband, who is usually right on the ball, realized I was hallucinating. I guess he saw something was really wrong when I told him that I thought the nurses were secretly filming me with hidden cameras! He refused to allow them to give me any more of the drug. Right after stopping it, I returned to normal, but I have a very deep and clear sense of self. I am sure for some people, the affects could be lasting.

  7. Wayne

    I had an MD/DO prescribe 10mg Prednisone for hip pain:
    4 tabs/day for 3 days, 3 tabs/day for 3 days, 2 tabs/day for 3 days,
    and 1 tab/day for 3 days.

    The brochure on it warned about overdosing. If you pass out, or have trouble breathing, call 911!

    I told the Dr. I was not going to take it, and “Goodbye, I am going to get a another opinion.

    My hip pain went away on its own.

  8. j

    I had a severe manic reaction to Biaxin, used for treating advanced pneumonia, about 13 years ago. Though I was on antidepressants at the time due to divorce anxiety, no cautions were given by the doctor and I doubt it was on the literature.

    I was given Serequel to counteract the mania, which lasted a few weeks. No doctor connected the reaction with Biaxin, though I insisted it was a reaction, never having had mania in the prior 35 years. My friends and family really thought I was severely mentally ill and that I had hidden it somehow until then. Some still do not believe my explanation of Biaxin reaction and treat me differently. It was a truly devastating event and I still have to deal with repercussions. Thank you for this article and confirmation!!

  9. Joyce

    Also know that a plain old Urinary Tract Infection can cause bizarre symptoms in elderly women. I had what I thought was a mild stroke last week, sudden feeling of having just awakened, lost time, forgot what I was doing at the kitchen sink or what I had planned to do during the day. I went to my Primary Care Physician’s for a flu shot but instead he did a mini neurological exam and suggested I get a CT scan. ER said I had “Altered Mental Status” secondary to a UTI. I knew I had a mild one which was unusual, but thought it would go away without antibiotics. I had no idea a minor UTI could alter my mental status.

  10. Beverly

    I had stents put in was prescribed brilinta and started having mental confusion dizziness losing my balance finally hallucinating but the doctors would not believe me until things went flying around the room so I thought. Took me months to recover puzzles seemed to help my brain reorganize itself

  11. Sharon

    I’m on everything mentioned iin this article and now I’m scared to death. What should I do (other than crouching in the corner)?

  12. Bonnie

    I had hallucinations from taking Demerol and Cipro. With the combo of Cipro & Flagyll for a bout of diverticulitis many yesrs back, I also developed Steven Johnson’s syndrome, which is a condition where the drug(s) cause blister like places to appear on various parts of the body. If it gets out of hand without treatment, one can be sent to a burn center because it affects the body like bad burns over much of the body. Thankfully, I reached my dermatologist in time, although I had diagnosed it myself by the Internet. ( not my recommendation). He put me on 11 prednisone at the beginning and it subsided the condition but the prednisone about drove me crazy. Recently I was put on prednisone and actually had an allergic reaction to it so no more for me! I am beginning to believe that man made meds are done so in the devil’s workshop! I am on one med now where I have put on about 15 lbs since last December. I know that many drugs are necessary but I believe that our Drs are over-prescribing!

  13. O.G.
    Spartanburg, SC

    I have written in this forum before about my personal experiences with Tramadol, Ultram (Tramadol by another name), other pre and post-surgery opioids, and, most perniciously, Cymbalta, prescribed as an analgesic. All had unpleasant psychiatric side effects, Cymbalta being the worst.

    To detail only the last case, Cymbalta, after three days of use, had me lying on the couch suddenly thinking about death — a little like J.K. Rowling’s “Moaning Myrtle” sitting in the u-bend of the toilet at Hogwarts (it wasn’t funny at the time) — and apparently saying to my husband “Am I at home?” He said, calmly, that yes, I was, ” and you’re not taking any more of that medication.”

    When I had come out from under the dark cloud, I filed a written complaint with the FDA, with a few additional strongly-worded comments about failed antidepressants marketed by drug companies as analgesics.

    I no longer take anything — anything — but the insulin for my Type 1 diabetes. I hope I never have to undergo surgery so I can be subjected to this kind if scary scenario again.

    Yes, doctors should — but in most cases don’t — explain the side effects of the drugs they’re persuaded to prescribe. Yes, they should — but in most cases don’t — closely monitor their patients’ reactions to them. And yes, the medical profession in general needs to quit ascribing adverse reactions to (dismissive and unprofessional) labeling categories like “sundowner’s syndrome.”

    For me, the journey through prescription drugs was a nightmare I hope never to experience again. I now have an immense respect for the blood/brain barrier, and want to do everything possible to make its task as easy as possible.

  14. dand e
    south africa

    My husband, after I had warned the doctor at the hospital he was sensitive to cortisone gave him a massive dose of cortisone for bronchospasm, which has left him permanently brain damaged with what they call “Sudden onset of dementia caused by Toxins”.
    The bronchospasm could have been managed differently.
    How do I cope with my anger?

  15. Dan
    Cary, NC

    I am a caretaker for an elderly woman who was prescribed tramadol for pain from shingles. She seemed to tolerate low dosages but beyond a certain threshold she began having vivid hallucinations and suffered a complete break from reality. For a brief time I feared she would need to be institutionalized, but thankfully her delusions vanished quickly after she ceased using the drug.

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