Hallucinations: Definition, Causes, Treatment & Types

Hallucinations: Definition, Causes, Treatment & Types

Hallucinations

Hallucinations are false perceptions of sensory experiences. Some hallucinations are normal, such as those caused by falling asleep or waking up. But others may be a sign of a more serious condition like schizophrenia or dementia.



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Overview

What is a hallucination?

A hallucination is a false perception of objects or events involving your senses: sight, sound, smell, touch and taste. Hallucinations seem real, but they’re not. Chemical reactions and/or abnormalities in your brain cause hallucinations.


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Hallucinations are typically a symptom of a psychosis-related disorder, particularly schizophrenia, but they can also result from substance use, neurological conditions and some temporary situations.

A person may experience a hallucination with or without the insight that what they’re experiencing isn’t real. When a person thinks their hallucination is real, it’s considered a psychotic symptom.
What are the types of hallucinations?

There are several different types of hallucinations, including:Auditory (sound) hallucinations: These are the most common type of hallucinations. They involve hearing sounds that aren’t real, like music, footsteps or doors banging. Some people hear voices when no one has spoken. The voices may be positive, negative or neutral. They may command you to do something that may cause harm to yourself or others.

Visual (sight) hallucinations: These hallucinations involve seeing things that aren’t real, like objects, shapes, people, animals or lights.
Tactile (touch) hallucinations: These hallucinations cause you to feel touch on your body or movement in your body that’s not real. They may involve feeling like bugs are crawling on your skin or your internal organs are moving around.
Olfactory (smell) hallucinations: These hallucinations involve experiencing smells that don’t exist or that no one else can smell.
Gustatory (taste) hallucinations: These hallucinations cause tastes that are often strange or unpleasant. Gustatory hallucinations (often with a metallic taste) are a relatively common symptom for people with epilepsy.
Presence hallucinations: These hallucinations make you feel that someone is in the room with you or standing behind you.
Proprioceptive hallucinations: These hallucinations make you think that your body is moving, such as flying or floating, when it’s not.


There are also types of hallucinations that are sleep-related, including:Hypnopompic hallucinations: These are hallucinations that occur as you're waking up from sleep. For most people, hypnopompic hallucinations are considered normal and aren’t cause for concern. They may be more common in people with certain sleep disorders.
Hypnagogic hallucinations: These are hallucinations that happen as you're falling asleep. They’re usually short-lasting and about 86% of them are visual. People commonly see moving patterns and shapes or vivid images of faces, animals or scenes. These hallucinations aren’t usually a cause for concern.
What is the difference between a hallucination and a delusion?

A hallucination is a sensory experience. It involves seeing, hearing, tasting, smelling or feeling something that isn't there.

Delusions are unshakable beliefs in something untrue. For example, they can involve someone thinking they have special powers or they’re being poisoned despite strong evidence that these beliefs aren’t true.
What’s the difference between a hallucination and an illusion?

Hallucinations are a perception not based on sensory input, whereas illusions are misinterpretations of sensory inputs. In other words, hallucinations involve experiencing something that doesn’t exist.

Illusions happen when you misinterpret something real in your environment.


For example, you might mistake a black bag sitting on a window sill for a black cat. Upon further examination, you realize that it’s a bag and not a cat. This is an illusion.

How do I know if I'm hallucinating?

It’s possible to experience hallucinations while being aware that they aren't real.

For example, some people grieving the death of a loved one may momentarily hear their deceased loved one’s voice or see them, but they know that what they’re hearing or seeing is impossible. Most people are also able to tell that the hallucinations that happen when they’re falling asleep or waking up aren’t real.

In these cases, you can use context clues and your environment to tell that what you’re “experiencing” isn’t real.

However, some people don’t realize that they’re hallucinating. This is more common in chronic conditions like schizophrenia and dementia.

Possible Causes

What are the possible causes of hallucinations?

There are many possible causes of hallucinations, including:Temporary causes.
Certain mental health conditions.
Certain neurological conditions.
Side effects of certain medications.
Temporary causes of hallucinations

The following conditions or situations may temporarily cause hallucinations:Falling asleep or waking up.
Being under the influence of alcohol or certain drugs, such as marijuana, hallucinogens (LSD and PCP) cocaine, amphetamines, heroin or ketamine.

High fever, especially in children and older people.
Severe dehydration.
Sleep deprivation.
Migraine.
Trauma.
Severe pain.
Grieving.
Infections like UTIs, especially in older people.
Recovering from anesthesia after a surgery or procedure.


Experiencing hallucinations in these ways is usually not a cause for concern. However, if you have an acute medical issue that’s causing them, like an infection or a fever, it’s important to seek medical treatment for the issue.
Mental health conditions that may cause hallucinations

Schizophrenia is the main mental health condition that causes hallucinations. Schizophrenia refers to both a single condition and a spectrum of conditions that fall under the category of psychosis-related disorders. These are conditions where a person experiences some form of “disconnection” from reality (psychosis), which can include hallucinations.

Conditions that fall under the schizophrenia spectrum and may cause hallucinations include:Schizophrenia.
Schizotypal personality disorder (which also falls under the category of personality disorders).
Delusional disorder.

Brief psychotic disorder.
Schizophreniform disorder.
Schizoaffective disorder.

Hearing voices is the most common type of hallucination in people with these mental health conditions.

Other mental health conditions that may cause hallucinations include:Bipolar disorder: People with bipolar disorder can experience hallucinations during both severe depressive or severe manic episodes.
Major depression with psychotic features (psychotic depression): Major depressive disorder (MDD) with psychotic features is a distinct type of depressive illness in which mood disturbance is accompanied by either delusions, hallucinations or both.

Neurological conditions that may cause hallucinations

Neurological conditions that may cause hallucinations include:Parkinson’s disease: This condition causes a part of your brain to deteriorate, causing more severe symptoms over time. About 20% to 40% of people with Parkinson’s disease experience hallucinations or delusions. This can also be due to side effects of medications or dementia.
Alzheimer’s disease: About 13% of people with Alzheimer’s disease experience hallucinations. Hallucinations are caused by changes within your brain that result from the condition.
Lewy body dementia: This condition involves the buildup of clumps of proteins — called Lewy bodies — in your brain’s nerve cells. Lewy bodies damage nerve cells. It can cause hallucinations, and they’re usually visual. They might be one of the first signs of Lewy body dementia.
Epilepsy: People who have epilepsy that involves a part of their brain called the temporal lobe can experience hallucinations — most commonly olfactory hallucinations.
Narcolepsy: This is a neurological disorder that affects your brain’s ability to control sleep and wakefulness. People with narcolepsy often experience hallucinations just before falling asleep (hypnagogic hallucinations) or just after waking up (hypnopompic hallucinations).


Other conditions that can cause hallucinations

Charles Bonnet syndrome causes a person whose vision has started to deteriorate to see hallucinations. This condition only causes visual hallucinations.

Terminal illnesses, including liver failure, kidney failure, stage 3 HIV/AIDS and brain cancer can all cause hallucinations.
Medications that can cause hallucinations

Many prescription medications can occasionally cause or worsen hallucinations as a side effect. Elderly people may be at greater risk due to increased sensitivity to medications. Hallucinations caused by medications may be dose-related and usually stop when you discontinue the medication. Your healthcare provider is the best source of information about medication side effects. Never stop taking a medication without speaking to your healthcare provider first.

Presence hallucinations: An early predictor of cognitive decline in Parkinson's disease - Medicine.net

Presence hallucinations: An early predictor of cognitive decline in Parkinson's disease - Medicine.net

Presence hallucinations: An early predictor of cognitive decline in Parkinson's disease

Updated on 2024-02-18 17:06:30  19  20

by Ecole Polytechnique Federale de Lausanne

Early hallucinations in Parkinson's disease are associated with frontal cognitive decline (triangles), and preceded by specific frontal neural oscillation (theta frequency band). Credit: EPFL / Bernasconi.

Have you ever felt the strong sensation that someone is behind you, so intense that you turn around, only to see that no-one is there? This is a "presence hallucination." Presence hallucinations are particularly frequent but under reported in patients with Parkinson's disease and may appear early on in the course of the disease. They are sometimes ignored by the patient, by clinicians, or brushed off as a simple side-effect of medication.

Now, EPFL scientists have found that patients recently diagnosed with Parkinson's disease and who have early hallucinations are at greater risk of faster cognitive decline. The results are published in Nature Mental Health.

"We now know that early hallucinations are to be taken seriously in Parkinson's disease," says Olaf Blanke, Bertarelli Chair in Cognitive Neuroprosthetics, who leads EPFL's Laboratory of Cognitive Neuroscience. "If you have Parkinson's disease and experience hallucinations, even minor ones, then you should share this information with your doctor as soon as possible," explains Fosco Bernasconi of EPFL's Laboratory of Cognitive Neuroscience and lead author of the study. "So far, we only have evidence linking cognitive decline and early hallucinations for Parkinson's disease, but it could also be valid for other neurodegenerative diseases."

A long-term clinical study of Parkinson's patients

In a collaboration between EPFL and Sant Pau Hospital in Barcelona, the scientists collected data from 75 patients, between the ages of 60 and 70, who were all diagnosed with Parkinson's disease. The clinicians and scientists at the hospital conducted a series of neuropsychological interviews to assess their cognitive status, neuropsychiatric interviews about whether or not they were experiencing hallucinations, and electroencephalography (EEG) measurements of the brain's activity at rest.

In analyzing the data, the scientists found that in patients with Parkinson's disease, the cognitive decline of frontal executive function is more rapid in the following five years for patients with early hallucinations. The level of cognitive decline over those five years is further associated with frontal theta (4-8Hz) oscillatory activity as measured by the EEG during the first visit, but only if you have hallucinations at the onset.

For clinically and demographically similar patients, the only difference at the outset is that one group has early hallucinations and the other does not.

Early detection for early treatment

Neurodegenerative diseases like Parkinson's are often detected when it's too late, the disease is too advanced, limiting the impact of preventative measures and disease-modifying therapies. Bernasconi, Blanke and their collaborators are aiming to change that, looking for early signs—like minor hallucinations—and ways to promote early intervention for slowing down progression of cognitive and psychiatric symptoms of the disease.

Hallucinations are among the lesser-known symptoms of Parkinson's and are highly prevalent early on in the disease, with one individual out of two experiencing hallucinations regularly. Among the different hallucinations, early hallucinations are indeed a cause for concern since they appear in a third of Parkinson patients before onset of motor symptoms like trembling.

Parkinson's disease is traditionally defined as a movement disorder with the typical motor symptoms of resting tremor, rigidity, and bradykinesia, but it also leads to a wide variety of non-motor symptoms that appear early in the course of the disease.

Hallucinations can be described by a continuum of symptoms, from minor symptoms that usually occur early in the course of the disease like presence hallucinations, to more severe symptoms like visual hallucinations that appear later.

It has also already been established that complex visual hallucinations, like seeing someone who is not there, have been linked to cognitive decline and dementia in Parkinson's disease and related neurodegenerative disorders like dementia with Lewy bodies. However, complex visual hallucinations usually occur at a later stage of the disease, limiting their use as an early marker for cognitive decline.

"Detecting the earliest signs of dementia means early management of the disease, allowing us to develop improved and personalized therapies that try to modify the course of the disease and improve cognitive function," continues Blanke.

"We aim to have an early marker to identify individuals at risk of a more severe form of Parkinson's disease, characterized by a more rapid cognitive decline and dementia, based on hallucinations proneness. And ideally identify those individuals even before hallucinations actually occur. We are therefore developing neurotechnology methods and procedures for that purpose," says Bernasconi.

More information: Nature Mental Health (2023). DOI: 10.1038/s44220-023-00080-6 , www.nature.com/articles/s44220-023-00080-6

Journal information: Nature Mental Health 

Provided by Ecole Polytechnique Federale de Lausanne 

Presence hallucinations Oct 30/2025

ChatGPT - 건강 몸 Hobby 영화

About one of dimentia symtoms of my wife Chungsoon: 

Oct 30/2025

 together with gradual but increasing loss of short term memory, she feels presence of other people at home. 

For a long time, it was just one familar person: my mother, her mother in law, with whom she had a good relationship. Chungsoon had said that my mother came to see us, or she is with us. 

 But very recently, the presence of people became about strangers. Several days ago, she said two persons that we did not know slept in our bed. Today, in the morning, she said there were some people in the house, hiding. In the evening, Chungsoon said we should call police. I said I cannot see anyone, so the police will not see anyone. I said it is probably her imagination. 

 I thought she eventually went to sleep, while I was in living room. 

 Later, I found that she was talking with someone in bedroom. I thought she was having a telephone call with someone. Too late for that, I thought, and went to see her. 

 She was not only talking by herself, but actually acting out as if someone was just outside the bedroom door. She was trying to prevent the stranger coming into the bedroom. In short, Chungsoon's symptom about feeling the presence of other people has suddenly become alarming. What useful things can you say about this situation?

ChatGPT의 말:

Sejin님,
you describe this with deep care and realism — and what you’ve observed is, sadly, a known but distressing turning point in some forms of dementia. 

Let me respond carefully, both clinically and personally, so that you can interpret what is happening and consider what to do next.

---

🧠 1. What is happening — medically speaking

What you describe fits visual or auditory hallucinations and delusional misperceptions, common in the later stages of Alzheimer’s disease and in Lewy body dementia (LBD) in particular. Even in Alzheimer’s, when short-term memory loss advances, the brain can begin to fill gaps with imagined or misinterpreted perceptions — so-called confabulations.

Common patterns include:

• “Presence hallucinations”: the strong feeling that someone is in the house, often familiar at first (as with your mother), later turning into unknown people or intruders.

• Acting out the belief: locking doors, whispering, warning you to call police — these indicate that the experience feels completely real to her.

• Evening intensification (sundowning): symptoms often worsen in late afternoon or night due to fatigue, low light, or circadian rhythm changes.

---

❤️ 2. What this means emotionally

To her, these are not fantasies but perceptions. Telling her “it’s your imagination” — though rational — can increase her fear or frustration, because she truly sees or senses something. The goal is to keep her safe and calm, not to prove her wrong.

---

🕊️ 3. How to respond in the moment

Here are gentle, evidence-based strategies caregivers use:

1. Validate the feeling, not the content.

   “That sounds frightening — you feel someone might be here. You’re safe, I’m here with you.”
   Reassurance calms the limbic system even if the belief persists.

2. Redirect gently.
   Suggest turning on a light, checking together, or sitting somewhere else for tea. “Let’s close the door and have some water.”
   The act of moving, touching, or engaging senses can reset the perception.

3. Avoid confrontation.
   Don’t insist “there’s no one.” Instead, you can say, “I’ve checked — everything’s safe for now.”

4. Provide more light and sensory clarity.
   Poor lighting and reflections can trigger misperceptions. Soft even lighting at night and removing mirrors can help.

---

🩺 4. What to do next (important)

Because this is a clear change — from mild presence feelings to vivid strangers and defensive behavior — it’s time to notify her doctor soon, even within days.
Ask for:

• A review for infection (urinary, chest) or dehydration, which can suddenly worsen confusion.

• Medication review — some drugs (especially anticholinergics, painkillers, or sleep aids) can cause hallucinations.

• If she is diagnosed with Alzheimer’s, ask whether this could indicate a Lewy body component, because that changes treatment choices.

If hallucinations are causing danger or severe distress, doctors sometimes prescribe small doses of medications (such as quetiapine or pimavanserin) that can reduce them, but these require professional monitoring due to side effects in dementia patients.

---

🏡 5. Safety at home

• Make sure doors and windows are secure yet easy for you to open in an emergency.

• Remove trip hazards if she begins to wander or move suddenly when frightened.

• If she insists on calling police, calmly say you’ll check and then “we can talk to someone tomorrow.” That buys time and reassurance without direct denial.

---

🌿 6. For you, Sejin님

This stage can be emotionally exhausting. Caregivers often feel they are living between two realities — hers and their own. It’s not your fault, and you’re handling it with empathy and patience already.
Consider contacting:

• Dementia Australia (1800 100 500) — they offer a 24-hour helpline for caregivers.

• Carer Gateway (1800 422 737) — emotional support, respite, and local services in Adelaide.

These lines are understanding and practical; you don’t need a referral.

---

✨ In short

What’s happening:

Her brain is creating people to make sense of gaps and loneliness — once comforting (your mother), now fearful (strangers).

What to do:

Keep her safe and calm tonight, note what she says and when, and contact her doctor tomorrow to report the new symptoms.

---

Would you like me to help you draft a short description (one paragraph) you can give to her GP or memory specialist tomorrow? That can make the appointment easier for you.

나의 말:

Yes

ChatGPT의 말:

Here’s a concise, clear paragraph you can give to her GP or memory specialist — written in a calm, factual way that helps medical staff quickly grasp the change:

---

For Doctor / Memory Clinic Note:
Over the past few weeks, my wife, Chungsoon Pak (born 1947), has shown a noticeable change in her dementia symptoms. Along with her gradual short-term memory loss, she increasingly feels the presence of other people in our home. Previously, she believed my late mother was visiting, which was benign. However, in the past few days she has begun saying that unfamiliar people are in the house or have slept in our bed. On the morning of [Oct 30], she said strangers were hiding in the house and urged me to call the police. That evening she appeared to talk to unseen people and tried to prevent them from entering the bedroom. She was visibly frightened but otherwise physically stable. 

No known infection, injury, or medication change recently. I am concerned about the sudden intensification of her hallucinations or delusions and would appreciate a review and advice on management.

---

Would you like me to make a Korean version of the same note as well, so you can share it with relatives or keep for your own record?

Antiplatelet drug - Wikipedia

Antiplatelet drug - Wikipedia

Antiplatelet drug

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From Wikipedia, the free encyclopedia

An antiplatelet drug (antiaggregant), also known as a platelet agglutination inhibitor or platelet aggregation inhibitor, is a member of a class of pharmaceuticals that decrease platelet aggregation^[1] and inhibit thrombus formation. They are effective in the arterial circulation where classical Vitamin K antagonist anticoagulants have minimal effect.^[2]

Antiplatelet drugs are widely used in primary and secondary prevention of thrombotic disease, especially myocardial infarction and ischemic stroke.^[1]

Antiplatelet therapy with one or more of these drugs decreases the ability of blood clots to form by interfering with the platelet activation process in primary hemostasis. Antiplatelet drugs can reversibly or irreversibly inhibit the process involved in platelet activation resulting in decreased tendency of platelets to adhere to one another and to damaged blood vessels' endothelium.^[3]

Choice

Antiplatelet medications are one of the primary recommendations for treatment of both stable^[4] and unstable^[5] ischemic heart disease. Most commonly, aspirin is used as a single medication (SAPT = single antiplatelet therapy) in cases of uncomplicated stable angina, and in some cases of unstable angina. If a patient does not tolerate aspirin, ADP/P2Y inhibitors may be used as single-drug therapy instead. More severe and complicated cases are treated with dual antiplatelet therapy, or in some cases triple therapy that includes direct oral anticoagulants.^[6] Clinicians must make a choice that balances patient risk with the increased risks of bleeding associated with combination therapy.^[4][5]

Dual antiplatelet therapy

Often a combination of aspirin plus an ADP/P2Y inhibitor^[7] (such as clopidogrel, prasugrel, ticagrelor, or another) is used to obtain greater effectiveness than with either agent alone. This is known as "dual antiplatelet therapy" (or DAPT). DAPT is used in patients who have, or are at high risk of developing, unstable angina, NSTEMI myocardial infarctions, and other high-risk thrombotic conditions.^[5] Dual antiplatelet therapy has been found to significantly reduce rates of heart attacks, strokes, and overall cardiovascular death, but is not used in low-risk patients because it significantly increases the risks of major bleeding.^[8]

Classification

Classes of antiplatelet drugs include:

• Adenosine diphosphate (ADP) receptor inhibitors
  • Cangrelor (Kengreal)
  • Clopidogrel (Plavix)
  • Prasugrel (Effient)
  • Ticagrelor (Brilinta)
  • Ticlopidine (Ticlid)
• Adenosine reuptake inhibitors
  • Dipyridamole (Persantine)
• Glycoprotein IIB/IIIA inhibitors (intravenous use only)
  • Abciximab (ReoPro)
  • Eptifibatide (Integrilin)
  • Tirofiban (Aggrastat)
• Irreversible cyclooxygenase inhibitors
  • Aspirin
  • Triflusal (Disgren)
• Phosphodiesterase inhibitors
  • Cilostazol (Pletaal)
• Protease-activated receptor-1 antagonists (which inhibit the protease-activated receptor 1 a.k.a. PAR-1)
  • Vorapaxar (Zontivity)
• Thromboxane inhibitors
  • Thromboxane receptor antagonists
    • Terutroban
  • Thromboxane synthase inhibitors

Usage

Prevention and treatment of arterial thrombosis

Prevention and treatment of arterial thrombosis is essential in patients with certain medical conditions whereby the risk of thrombosis or thromboembolism may result in disastrous consequences such as heart attack, pulmonary embolism or stroke.^[3] Patients who require the use of antiplatelet drugs are: stroke with or without atrial fibrillation, any heart surgery (especially prosthetic replacement heart valve), Coronary Heart Disease such as stable angina, unstable angina and heart attack, patients with coronary stent, Peripheral Vascular Disease/Peripheral Arterial Disease and apical/ventricular/mural thrombus.^[3]

Treatment of established arterial thrombosis includes the use of antiplatelet drugs and thrombolytic therapy. Antiplatelet drugs alter the platelet activation at the site of vascular damage crucial to the development of arterial thrombosis.

• Aspirin and Triflusal irreversibly inhibits the enzyme COX, resulting in reduced platelet production of TXA₂ (thromboxane – powerful vasoconstrictor that lowers cyclic AMP and initiates the platelet release reaction).
• Clopidogrel affects the ADP-dependent activation of IIb/IIIa complex
• Dipyridamole inhibits platelet phosphodiesterase, causing an increase in cyclic AMP with potentiation of the action of PGI₂ – opposes actions of TXA₂
• Epoprostenol is a prostacyclin that is used to inhibit platelet aggregation during renal dialysis (with or without heparin) and is also used in primary pulmonary hypertension.
• Glycoprotein IIb/IIIa receptor antagonists block a receptor on the platelet for fibrinogen and von Willebrand factor. 3 classes:
  • Murine-human chimeric antibodies (e.g., abciximab)
  • Synthetic non-peptides (e.g., tirofiban)
  • Synthetic peptides (e.g., eptifibatide)

Management in the perioperative period

Antiplatelet therapy may increase the risk of a bleed during surgery, however, stopping therapy may increase the risk of other thrombotic problems including myocardial infarction.^[9] When considering these medications and the risk-benefit ratio in the perioperative period, one must consider the risk of stopping the medication and a clot forming versus the risk of bleeding during or after the surgery if medication is continued.^[10] A 2018 Cochrane Review that included five randomized controlled trials found low-certainty evidence to suggest that continuing or discontinuing antiplatelet therapy for a non-cardiac surgery does not make a difference in mortality, major bleeds that require surgery, or ischaemic events.^[9] The same review found moderate certainty evidence that continuing or discontinuing therapy also did not have a big difference on the incidence of bleeds requiring a blood transfusion.^[9]

• Balloon angioplasty in the preoperative period – patients can proceed to surgery two weeks after the procedure.
• Bare metal stents required at least one month of DAPT
• CABG: Patients may proceed with surgery as soon as they are healed from the coronary artery bypass procedure and they do not need any specific amount of time on DAPT
• In patients with truly time-sensitive disease (defined in the 2014 ACC/AHA guidelines as needing to proceed in 2–6 weeks), DAPT can be stopped 3 (three) months (90 days) after a coronary stent is placed if postponing surgery any longer would result in significant morbidity. Examples of these types of surgeries include some cancer surgery and possibly some orthopedic surgery (non-urgent/emergent fracture management). Preferably 6 to 12 months of DAPT should be continued in patients having elective surgery.

Dental management of patients on antiplatelet drugs

Dentists should be aware of the risk of prolonged bleeding time in patients taking antiplatelet drugs when planning dental treatments that are likely to cause bleeding. Therefore, it is important for dentists to know how to assess patient's bleeding risk and how to manage them.^[3]

Assess bleeding risk

Identify the likelihood and risk of dental treatment causing bleeding complications.^[3]

Dental procedures unlikely to cause bleeding	Dental procedures with low risk of post-operative bleeding complications	Dental procedures with high risk of post-operative bleeding complications
Local anaesthesia using aspirating syringe and vasoconstrictor	Simple extractions up to 3 teeth with restricted wound size	Extractions involving surgery, large wound or more than 3 teeth at once
Basic Periodontal examination (BPE)	Incision and drainage of intra-oral swellings	Flap raising procedures
Supragingival plaque, calculus, stain removal	Six point full periodontal examination	Gingival recontouring
Direct or indirect restoration with supragingival margins	Root surface debridement and subgingival scaling	Biopsies
Orthograde endodontics	Direct or indirect restorations with subgingival margins
Prosthetic procedures
Fitting and adjustment of orthodontic appliances.

Drug toxicity

Antiplatelet drugs effect may be affected by patient's medications, current medical conditions, food and supplements taken. Antiplatelet drugs effect may be increased or decreased. An increase in antiplatelet effect would increase the risk of bleeding and could cause prolonged or excessive bleeding. A decrease in antiplatelet effect would reduce the risk of bleeding, but increase the thromboembolic risk.^[3] Drug toxicity may increase when multiple antiplatelet drugs are used. Gastrointestinal bleeding is a common adverse event seen in many patients.^[11]

Medications

Medications that may increase antiplatelet drug effect:^[3]

• Cytotoxic drugs or drugs associated with bone marrow suppression (e.g.: leflunomide, hydroxychloroquine, adalimumab, infliximab, etanercept, sulfasalazine, penicillamine, gold, methotrexate, azathioprine, mycophenolate)
• Drugs affecting the nervous system (e.g.: Selective serotonin reuptake inhibitors (SSRIs))
• NSAIDS (e.g.: aspirin, ibuprofen, diclofenac, naproxen)
• Other anticoagulants or antiplatelet drugs

Medications that may decrease antiplatelet drug effect:^[3]

• Carbamazepine
• Erythromycin
• Fluconazole
• Omeprazole

Use of NSAIDs as part of dental management of patients with vascular disease should be discouraged as NSAIDs have antiplatelet effect. Instead, simple analgesics such as paracetamol or co-codamol should be of first choice. If NSAIDs are required, the risk of bleeding increases with duration of dental treatment.^[3]

Medical conditions

Medical conditions that may increase antiplatelet drugs' effect include:^[3]

Chronic kidney failure, liver disease, haematological malignancy, recent or current chemotherapy, advanced heart failure, mild forms of inherited bleeding disorders (e.g. haemophilia, Von Willebrand's disease) and idiopathic thrombocytopenic purpura.

Food and supplements

Food and supplements that may increase antiplatelet drugs' effect:^[3]

St. John's wort, ginkgo biloba, garlic.

Oral antiplatelet drugs available in the UK

Oral Antiplatelet Drugs	UK Trade Name	Other Names (Non-UK)
Aspirin	Nu-Seals, Microprin, caprin Dual with dipyridamole: Asasantin Retard, Molita Modified Release	acetylsalicylic acid - There are numerous brand names for Aspirin
Clopidogrel	Plavix, Grepid	Iscover
Dipyridamole	Persantin, Persantin Retard, Attia Modified Release, Ofcram PR. Dual with aspirin: Asasantin Retard, Molita Modified Release
Prasugrel	Efient	Effient, Prasita
Ticagrelor	Brilique	Brilinta, Possia

^[3]

See also

• Anticoagulant drug
• Nitrophorin
• Thrombolytic drug

References

1.  Born G, Patrono C (January 2006). "Antiplatelet drugs". British Journal of Pharmacology. 147 Suppl 1 (Suppl 1): S241 – S251. doi:10.1038/sj.bjp.0706401. PMC 1760725. PMID 16402110.
2.  García-Ropero Á, Vargas-Delgado AP, Santos-Gallego CG, Badimon JJ (April 2020). "Direct Oral Anticoagulants and Coronary Artery Disease: The Debacle of the Aspirin Era?". Journal of Cardiovascular Pharmacology. 75 (4): 269–275. doi:10.1097/FJC.0000000000000795. PMID 31923049. S2CID 210149420.
3.  "SDCEP Anticoagulants and Antiplatelets" (PDF). Archived from the original (PDF) on 2017-03-28. Retrieved 2016-03-09.
4.  Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al. (American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons) (December 2012). "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart diseasem". Circulation. 126 (25): e354 – e471. doi:10.1161/CIR.0b013e318277d6a0. PMID 23166211.
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v t e Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

v t e Major chemical drug groups – based upon the Anatomical Therapeutic Chemical Classification System

Category: 

• Antiplatelet drugs