A Case Report on Atropine Induced Psychosis

The administration of atropine to a large population for treatment of intoxication carries the risk of allergic or toxic reactions in a small number of patients. It has been reported rarely in the literatures .We describe a cases of atropine-induced psychotic disorder in a substance abused patient and different approaches of management. Dryness of the mouth, blurred vision, photophobia and tachycardia commonly occur with chronic administration of doses. In addition psychotic symptoms such as restlessness and excitement, hallucinations, delirium may occur due to atropine. This is a study of a 55 year old female patient who manifested with visual and auditory hallucination, fatigue, anxiety, headache visual disturbances and chest tightness after intake of atropine. To manage this adverse drug reaction the dose of atropine was progressively reduced to 1ml/hr and 0.5ml/hr and discontinued after appearance of signs of complete atropinization. Patient was given with IV morphine 2 mg/hr to manage agitation and IV haloperidol 5mg as required to managing the psychiatric effects. Physostigmine, scopolamine or glycopyrrolate was given in some cases as replacement of therapy in atropine-induced psychosis. In this case, symptomatic treatment is appropriate as it is substance abused patient, no long term therapy is needed for the patient and anticholinergic toxicity is likely to resolve within days of discontinuing the offending agent. INTRODUCTION: Atropine is an anticholinergic which inhibits the muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites including smooth muscle, secretory glands and CNS sites. Atropine Sulfate used as a pre-anesthetic medication in surgical patients to reduce salivation and bronchial secretions and suppress vagal activity associated with the use of halogenated hydrocarbons during inhalation anesthesia and reflex excitation arising from mechanical stimulation during surgery. QUICK RESPONSE CODE DOI: 10.13040/IJPSR.0975-8232.7(1).387-91 Article can be accessed online on: www.ijpsr.com DOI link: http://dx.doi.org/10.13040/IJPSR.0975-8232.7 (1).387-91 The antispasmodic action of Atropine is useful in pylorospasm and other spastic conditions In poisoning by the organic phosphate cholinesterase inhibitors found in certain insecticides and by chemical warfare nerve gases, large doses of Atropine relieve the muscarinic-like symptoms and some of the central nervous system manifestations. The CNS effects of the atropine are Headache, flushing, nervousness, drowsiness, weakness, dizziness and insomnia. Objective: We describe a case of atropine-induced psychotic disorder in a substance abused patient and different approaches of treatment 1 . Case presentation: A 55 year old male patient was admitted to the hospital with sudden onset of breathlessness and