I’ve spent rather more time than I’d like in hospitals over the past few months. Supporting family, that is, not as the patient myself. Somewhat humorously, one of those people was prescribed the same drug as their cats during their stay. I thought it was funny, anyway.
In one case, my loved one was required to stop taking a medication they’d been taking for a very long time indeed, and this triggered weird perceptual side effects – sparkly bits. Either they’d developed the ability to see things that other people couldn’t, or these were hallucinations.
Which got me thinking. This was a withdrawal effect, but what other weird side effects can medications have?
Let’ start with ropinirole (this is the generic name, it has fancier brand names). Ropinirole is prescribed for two main issues: Parkinson’s disease, a progressive disease of the nervous system that affects movement, and Willis-Eckbom disease, more colloquially known as restless leg syndrome.
Ropinirole has a bunch of fairly innocuous side effects, such as nausea, vomiting and stomach-ache, but it also has some rarer side effects, including hallucinations and delusions. Hallucinations involve sensory experiences of things that aren’t real; delusions are beliefs that have no basis in reality.
Medsafe’s medication information for ropinirole says users should contact their doctor immediately if they develop any “unusual behaviour changes”. Among those associated with the drug are impulsive behaviours, including pathological gambling, binge eating, compulsive spending and increased sex drive.
Why does ropinirole have these particular side effects? Hard to say conclusively, but it works by copying the dopamine that is naturally produced in our brains. It’s a cliché to describe dopamine as our “happy” or “pleasure” neurotransmitter, implicated in a lot of reward-seeking behaviour. As well as dampening restless legs and Parkinson’s symptoms, it makes us more sensitive to things that make us feel good.
On the subject of sexual urges, most adults will have heard of sildenafil citrate, right? Okay, it’s better known as Viagra, aka the “little blue pill”. It is mainly used by men to treat erectile dysfunction. But among sildenafil citrate’s more boring side effects (dizziness, flushing, headaches, etc), is a particularly odd one: visual disturbance. Specifically, you might experience a blue tinge to your vision. Technical term: cyanopsia.
Again, why? Sorry, but we’ll need to start by understanding how erections work. Sexy thoughts trigger the release of a chemical messenger we’ll refer to as cGMP that increases blood flow to the penis. Up goes the flag pole, until the cGMP is broken down by the protein phosphodiesterase-type 5 (or PDE-5). Viagra inhibits PDE-5.
Remember that a lot of our chemical messengers work like keys searching for the right lock. They float around until they find a lock they fit, which triggers whatever process the lock is associated with.
But, just like a key might be not quite right but similar enough to another to open the wrong lock, Viagra can also jemmy something else – the locks associated with PDE-5′s cousin, PDE-6. Where is PDE-6? Exclusively in the photoreceptors in our eyes. Ta-da, the blue balance gets turned up.
Seeing as we’re on a roll, let’s stick with blue-related side effects. Let’s imagine you got up in the night to use the bathroom and, probably to your consternation, your stream is blue! Unless you’ve been using Viagra and you’re just imagining it, urine that is actually blue can be a side effect of the antidepressant amitriptyline, propofol (an anesthetic), or indomethacin (a painkiller).
The reason here isn’t anything fancy involving chemical messengers, but simply that these drugs are often artificially coloured. Finally, is your skin turning blue? Check your drugs for silver.
