Paradoxical reaction

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Benzodiazepines can sometimes cause a paradoxical worsening of EEG readings in patients with seizure disorders.[7]


Phenobarbital can cause hyperactivity in children.[clarification needed] This may follow after a small dose of 20 mg, on condition of no phenobarbital administered in previous days.[8] Prerequisity for this reaction is a continued sense of tension. The mechanism of action is not known, but it may be started by the anxiolytic action of the phenobarbital.




Antidepressants can rarely make users obsessively violent or have suicidal compulsions, which is in marked contrast to their intended effect. This can be regarded as a paradoxical reaction but, especially in the case of suicide, may in at least some cases be merely due to differing rates of effect with respect to different symptoms of depression: If generalized overinhibition of a patient's actions enters remission before that patient's dysphoria does and if the patient was already suicidal but too depressed to act on his/her inclinations, the patient may find him/herself in the situation of being both still dysphoric enough to want to commit suicide but newly free of endogenous barriers against doing so.[10] Children and adolescents are more sensitive to paradoxical reactions of self-harm and suicidal ideation while taking antidepressants but cases are still very rare.[11]




  1. ^ Bramness JG, Skurtveit S, Mørland J (June 2006). "Flunitrazepam: psychomotor impairment, agitation and paradoxical reactions". Forensic Sci. Int. 159 (2–3): 83–91. doi:10.1016/j.forsciint.2005.06.009. PMID 16087304. 
  2. ^ Cole JO; Kando JC. (1993). "Adverse behavioral events reported in patients taking alprazolam and other benzodiazepines". The Journal of clinical psychiatry. 54 (Suppl:49–61): 62–3. PMID 8262890. 
  3. ^ Senninger JL; Laxenaire M. (1995). "[Violent paradoxal reactions secondary to the use of benzodiazepines]". Annales médico-psychologiques. 153 (4): 278–81. PMID 7618826. 
  4. ^ Mancuso, Carissa E.; Tanzi, Maria G.; Gabay, Michael (September 2004). "Paradoxical Reactions to Benzodiazepines: Literature Review and Treatment Options". Pharmacotherapy. 24 (9): 1177–1185. doi:10.1592/phco.24.13.1177.38089. PMID 15460178. 
  5. ^ "Letter: Tranquilizers causing aggression". British medical journal. 1 (5952): 266. February 1, 1975. doi:10.1136/bmj.1.5952.266. PMC 1672080Freely accessible. PMID 234269. 
  6. ^ Berman ME, Jones GD, McCloskey MS (February 2005). "The effects of diazepam on human self-aggressive behavior". Psychopharmacology (Berl.). 178 (1): 100–6. doi:10.1007/s00213-004-1966-8. PMID 15316710. 
  7. ^ Perlwitz R; Grimmberger E; Schmidtsdorf R (June 1980). "[Immediate effect of intravenous clonazepam on the EEG]". Psychiatr Neurol Med Psychol (Leipz). 32 (6): 338–44. PMID 7403357. 
  8. ^
  9. ^ Chlorpromazine - Adverse Effects- Behavioral Reactions[dead link]
  10. ^ Teicher MH, Glod C, Cole JO (February 1990). "Emergence of intense suicidal preoccupation during fluoxetine treatment". Am J Psychiatry. 147 (2): 207–10. PMID 2301661. 
  11. ^ King RA, Riddle MA, Chappell PB, et al. (March 1991). "Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment". J Am Acad Child Adolesc Psychiatry. 30 (2): 179–86. doi:10.1097/00004583-199103000-00003. PMID 2016219. 
  12. ^ Eagle H, Musselman AD (July 1948). "The rate of bactericidal action of penicillin in vitro as a function of its concentration, and its paradoxically reduced activity at high concentrations against certain organisms". J Exp Med. 88 (1): 99–131. doi:10.1084/jem.88.1.99. PMC 2135799Freely accessible. PMID 18871882.