Procainamide-Induced Psychosis-Reply

We appreciate Dr Menken's comments and the opportunity to respond. We were not suggesting that this patient's behavior was due to a functional psychosis but only that his mental status examination was consistent with such a state. By this we meant that schizo-affective disorders are occasionally similar and that disorientation and impairment of memory, information, and ability to calculate were never such that would be inconsistent with manicdepressive illness or schizophrenia. Alterations in motor activity, sleep patterns, attention span, affect, social restraint, and judgment were present but were nonspecific findings and did not help clarify the diagnosis. We believe that this episode of aberrant behavior was drug induced (organic) but that delirium was absent. Because organic mental disorders can occur without evidence of delirium, they can imitate a variety of psychiatric syndromes. Perhaps the best known example of this is reserpine-induced depression. We described this patient as having