What the Heck is A
Paradoxical Reaction …
A Paradoxical Reaction to any substance can be frightening and uncomfortable. Learn about what these adverse drug reactions are and how to manage them. A Paradoxical reaction is an adverse reaction to a substance, almost always to a drug, that is EXACTLY THE OPPOSITE of the intended effect.
The word 'Paradoxical' is defined as, "… a contradiction or a situation which defies intuition." And that's exactly what these drug reactions are, a seemingly contradictory reaction to a drug that is nonetheless very very real.
A Real Life Problem
A common example of this type of reaction reaction in medicine is the case of a drug called Compazine. Compazine is a drug given intravenously in hospitals for nausea and/or for migraine headaches. Approximately 20% of people have a paradoxical reaction to compazine that then requires the administration of intravenous Benadryl – also called diphenhydramine- to resolve.
When someone has these reactions, it is VERY obvious to a knowledgeable medical profession- but less obvious to the patient and family. Patients become restless, agitated and can't sit still. In many cases, they actually do not know what is going on- all they know is that they 'Want to Go Home." They will repeatedly state that they want to go home or that they, "Have to get out of here" over and over.
For the medical professional, the trick is to get a dose of intravenous Benadryl into the patient as quickly as possible, otherwise the attempt to get the patient to stay longer and wait for test results, the doctor to talk to them, etc. can turn into anger for the patient who wants to leave and for the family who wants to honor the patient's request and doesn't understand what is going on.
-Kerri Knox, RN
San Francisco, Ca
What to do About A
Paradoxical Reaction
If you have one at home, you can take a dose of Benadryl to help reverse the anxiety and restlessness. But if you understand what it is and that it is not dangerous, then you could simply wait it out or go for a walk until the side effect wears off. If you are at the hospital, you can notify the nurse or doctor what you think is happening and they will be likely to give you some Benadryl to alleviate it.
You'll need to notify your doctor and get a new drug recommended for your initial problem, as you cannot take that drug (or similar drugs in the same class) again.
Paradoxical Reactions in Children
Compazine is not the only drug that often has a paradoxical reaction, however; caffeine can also lead to some interesting reactions too. For instance, most people experience Caffeine Side Effects as jitteryness and anxiety. However most children have a paradoxical reaction to caffeine and some other stimulants, calming them down rather than stimulating them.
This action of what normally are stimulants allowing children to calm down led to the development of ADHD drugs, such as Adderral, that are similar in structure and function to the stimulant methamphetamines. While the side effects of Adderal and other stimulant drugs for ADHD are a separate topic for another page, the inherent paradoxical reaction most children have to caffeine and other stimulants is an interesting one that many parents have discovered on their own.
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