Donepezil for anticholinergic drug intoxication: a case report

Area of Science:

• Neuroscience
• Pharmacology
• Toxicology

Background:

• Anticholinergic toxicity is a common cause of delirium, particularly in overdose cases.
• Amitriptyline, a tricyclic antidepressant, possesses significant anticholinergic properties.
• Management of drug-induced delirium often involves supportive care, but specific antidotal therapies are limited.

Observation:

• A case of delirium was observed in a patient following an overdose of amitriptyline.
• The patient presented with symptoms consistent with anticholinergic toxicity.
• Delirium symptoms were monitored closely during the clinical course.

Findings:

• Rapid resolution of delirium was achieved after the administration of donepezil, a cholinesterase inhibitor.
• Cholinesterase inhibitor therapy demonstrated a significant positive effect on the patient's mental status.
• The patient's recovery was prompt and complete without apparent sequelae.

Implications:

• Cholinesterase inhibitors may represent a viable therapeutic option for managing anticholinergic drug-induced delirium.
• Further research into the efficacy of cholinesterase inhibitors in similar clinical scenarios is warranted.
• This case highlights a potential pharmacological approach to mitigate the effects of anticholinergic toxicity.