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[Toxic psychoses from atropine and scopolamine]
1Integrierter forensisch-psychiatrischer Dienst der Universität Bern Universitätsnervenklinik Psychiatrie-Psychotherapie Homburg/Saar.
Fortschritte Der Neurologie-Psychiatrie
|August 11, 1998
Summary
Psychoses from atropine and scopolamine intoxication, though rarely published, present with dose-dependent anticholinergic blockade symptoms. This review covers history, pathophysiology, and clinical presentations, including four case studies.
Area of Science:
- Toxicology
- Psychiatry
- Pharmacology
Background:
- Atropine and scopolamine, ancient alkaloids, are still used today.
- Intoxication by these substances is rarely documented in scientific literature.
- These alkaloids are known for their anticholinergic properties.
Purpose of the Study:
- To present the history, pathophysiology, and clinical symptoms of atropine and scopolamine intoxication.
- To review existing literature on solanaceae alkaloid toxicity.
- To introduce four recently observed cases of intoxication.
Main Methods:
- Literature review on atropine and scopolamine intoxication.
- Clinical observation and case study documentation.
- Analysis of central and peripheral anticholinergic effects.
Main Results:
- Intoxication presents a dose-dependent syndrome with specific central and peripheral symptoms.
- Psychiatric manifestations range from excitement and hallucinations to stupor and coma.
- Anticholinergic blockade of muscarine receptors is the primary mechanism.
Conclusions:
- Atropine and scopolamine intoxication, while uncommon in publications, requires recognition due to severe psychiatric and physiological effects.
- Understanding the anticholinergic mechanism is crucial for diagnosis and management.
- Further case reporting is valuable for understanding this toxicity.