Psychotic-like reaction to procaine penicillin G

A patient developed a psychotic-like reaction immediately after receiving an intramuscular injection of procaine penicillin G. The patient complained of a metallic taste, dizziness, ringing of the ears, and the fear of imminent death. No cardiovascular or pulmonary disturbances were noted. The reaction and all symptoms resolved within 15 minutes, and the patient has reported no further episodes. The case and a review of the literature are presented.