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This chapter will not be concerned with the psychotropic drugs prescribed for psychiatric or behavioral indications, which are the subject of other chapters in this volume. Instead it addresses the psychoactive effects of general medical drugs used in the treatment of children and adolescents with physical illnesses. This is an area that has not been previously addressed in the scientific literature. “Psychoactive” effects will refer to acute or subacute effects in the behavioral, emotional, or cognitive domain. They will not include the results of irreversible or structural brain effects from other causes. Anticonvulsant (antiepileptic) drugs are also excluded since they are the subject of Chapter 12. For reasons of economy and to avoid unnecessary repetition, the term children will include adolescents unless otherwise indicated.

The potentiation of the anticholinergic effects of one drug by another is frequently overlooked as a cause of acutely developing psychosis. This is not surprising considering that more than 600 drugs with significant anticholinergic properties are currently commercially available (Alpern and Marriot, 1973). This paper defines the central anticholinergic syndrome (CAS), its forms of presentation, etiology, pharmacology, and management.

The results shown are from a survey of unselected patient prescriptions collected from six different hospitals over the years stated. The intervals sampled varied between three and 12 months with a mean period of 5.4 months.

Through the study of the pharmacological and clinical actions of chlozapine, a new drug used in psychiatry, we are questioning one of the traditional statements on the therapeutic action of antipsychotics: the affirmation that those must have, concomitantly, antipsychotic action and intense extrapyramidal effects (druginduced parkinsonism).