Identification and Treatment of Acute Psychotic States Secondary to the Usage of Over-the-Counter Sleeping Preparations
KENNETH C. ULLMAN M.D.1, and
ROBERT H. GROH M.D.2
1 Second-year resident in psychiatry at Georgetown University Hospital, Washington, D.C. 20007
2 Chairman, Department of Psychiatry, Washington Hospital Center, and Clinical Professor of Neurology, George Washington University Medical Center
Within eight months, 36 patients seen at the Washington Hospital Center, Washington, D.C., presented the problem of differentiating between a toxic psychosis caused by ingestion of over-the-counter sleeping medications containing scopolamine and a schizophrenic episode. Clinical evaluations, case histories, and thin-layer chromatography were used to identify these patients. Urinalysis revealed the presence of at least two ingredients of over-the-counter sleeping medications in ten patients. Intramuscular injections of physostigmine salicylate reversed the toxic psychosis presumed to be the result of the scopolamine content in these preparations.
