Hypersensitivity to antimuscarinic agents following brief exposure to Soman and Sarin

Behavioral responses to atropine in rats exposed to the potent anticholinesterase agents Soman and Sarin were studied. Atropine itself produced limb-shakes and certain stereotyped activities, in a dose-dependent manner. The neurotoxicity elicited by Soman and Sarin was antagonized by atropine, while at the same time the responses induced by the latter were attenuated. In contrast, where rats were challenged with atropine 6-72 h after giving single doses of Soman or Sarin, the limb-shake myoclonus was markedly enhanced. The atropine-induced stereotypies were not, however, significantly affected, except for an increase seen at 24 h after Sarin treatment. Repeated treatment with Soman for 3 wk also led to similar supersensitivity of atropine-induced responses. The peripheral muscarinic receptor antagonist, methylatropine, produced no such hyperactivity on its own or at any time after anticholinesterase exposure. The rapid occurrence of hypersensitivity to antimuscarinic compounds following exposure to these anticholinesterases, therefore, suggests the need for observation of subjects who are poisoned with such agents and treated with antimuscarinics, for adverse reactions such as myoclonus during the critically sensitive period, especially if repeated antimuscarinic therapy is carried out.