Central anticholinergic syndrome in a child: a case report

A 2-year-old boy developed classical signs and symptoms of the central anticholinergic syndrome after ingesting twenty 4-mg tablets of the antihistamine cyproheptadine (Periactin). His symptoms were dramatically reversed by the intravenous administration of physostigmine. The physiology of the anticholinergic system and physostigmine are discussed along with the indications, toxicity, and dosing of physostigmine.