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Anticholinergic psychosis.

P J Perry, D C Wilding, R P Juhl

American Journal of Hospital Pharmacy

|June 1, 1978

Summary

This summary is machine-generated.

Anticholinergic psychosis in a 17-year-old male was treated effectively. Physostigmine salicylate is recommended for reversing anticholinergic poisoning symptoms.

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Area of Science:

Toxicology
Neuropsychiatry
Pharmacology

Background:

Anticholinergic toxicity can mimic other psychiatric and medical conditions.
Benztropine mesylate is a common anticholinergic agent with potential for abuse or accidental overdose.

Observation:

A 17-year-old male presented with acute psychosis and physical signs of anticholinergic intoxication, including mydriasis, tachycardia, and hypertension.
The patient had borderline intellectual functioning.
Initial treatment involved sedation with chlorpromazine hydrochloride and haloperidol.

Findings:

Differential diagnosis considered amphetamine intoxication but was ruled out by a negative urine assay.
The patient's symptoms, short psychosis duration, and physical signs were consistent with benztropine mesylate overdose.

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Physostigmine salicylate is identified as the primary treatment for reversing anticholinergic poisoning.

Implications:

This case highlights the importance of considering anticholinergic toxicity in acute psychosis presentations.
Prompt diagnosis and appropriate treatment, such as physostigmine, are crucial for managing anticholinergic poisoning.
Avoidance of phenothiazines for sedation in anticholinergic toxicity is advised due to potential to worsen symptoms.