Reversal of Delirium Induced by Tricyclic Antidepressant Drugs with Physostigmine
JON F. HEISER M.D.1, and
DONALD E. WILBERT M.D.2
1 Assistant Adjunct Professor, Department of Psychiatry and Human Behavior, California College of Medicine, University of California, Irvine and Assistant Chief, Adult Psychiatric Inpatient Service, Orange County Medical Center, Orange, Calif. 92668
2 Clinical Instructor, Department of Psychiatry and Human Behavior, California College of Medicine, University of California, Irvine and Staff Psychiatrist, Adult Psychiatric Inpatient Service, Orange County Medical Center, Orange, Calif. 92668
The authors found that 2 mg. of physostigmine given intramuscularly was effective in reversing acute brain syndromes in two patients who had ingested toxic doses of drugs with anticholinergic properties (amitriptyline alone and an amitriptyline-perphenazine combination). Physostigmine also controlled one patient's tachycardia and tachypnea. Physostigmine may not control toxic effects of anticholinergic drugs when these effects are not mediated through cholinergic blockade.
