Patient-reported multiple drug reactions: clinical profile and results of challenge testing.
In order to evaluate pseudoallergic reactions to drugs, we studied a particular group of patients intolerant towards many drugs, pharmacologically dissimilar and administered during different periods of time. These patients consider themselves as "allergic" to "all" drugs. Twenty female patients, all with a history of intolerance to at least three drugs, chemically and antigenically dissimilar and not belonging to the same category of drugs, were studied. These patients underwent an allergological testing (negative in all cases) and a psychodiagnostic test (Rorschach's test); the latter was also performed in 20 normal control subjects. The psychodiagnostic findings demonstrated the negative psychological constitution of the experimental group in which the presence of a smaller quantity of energy leads to a minor capability of expressing emotions and to a major expression of depressive feelings. These patients suppress emotions to a greater extent, probably because of an expressive inhibition, while in the control group there is a possibility of mental elaboration. This implies that during the early period of emotional development with their parents, attempts to express affection received negative and frustrating replies. Therefore in later development, the expression of affection was suppressed. This last dynamic consideration, together with the former energetic and structural findings, demonstrates the pathogenic complexity of multiple drug intolerance, including, together with dysmetabolic, hormonal (clear prevalence of female subjects), autonomic and dysreactive factors, an important psychosomatic component. The diagnosis therefore also includes a careful psychodiagnostic test.