Q:  Phenergan & Chlorpheniramine

Have you had patients that react to phenergan or chlorpheniramine?  I had two separate manic episodes that my pdoc thought might have been precipitated by taking these meds.  He stated that this had happened before with a couple of his patients.  Why do you think that it causes the manic?  Are there other similar drugs that I need to be careful about taking?  I would appreciate any help that you can offer.  

Thank you, Marlene

Dear Marlene  -- 

I’ve gotten way behind on replies so am opting for now to be "short and sweet" (hopefully, and hopefully still useful):

Phenergan, no; chlorpheniramine, yes.  The latter is a stimulant and several stimulants have done this, including e.g. Sudafed (pseudephedrine). 

Others?  Alcohol, steroids, and certainly antidepressants.  Beyond that, there's less we know to watch for.  Thyroid at doses sufficient to induce hyperthyroidism would probably count. 

Dr. Phelps

Published November, 2001