Prolonged Antimuscarinic Delirium in a Child Due to Benztropine Exposure Treated With Multiple Doses of Physostigmine

An 11-year-old boy presented with an antimuscarinic toxidrome due to benztropine and risperidone ingestion. His delirium was prolonged and difficult to treat with benzodiazepines. Multiple doses of physostigmine successfully treated it. Benztropine is a potent antimuscarinic agent, whereas risperido...

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Bibliographic Details
Published inPediatric emergency care Vol. 32; no. 4; p. 243
Main Authors Thornton, Stephen L, Farnaes, Lauge, Minns, Alicia
Format Journal Article
LanguageEnglish
Published United States 01.04.2016
Subjects
Benztropine - adverse effects
Child
Cholinesterase Inhibitors - administration & dosage
Delirium - chemically induced
Delirium - drug therapy
Humans
Male
Muscarinic Antagonists - adverse effects
Physostigmine - administration & dosage
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Summary:An 11-year-old boy presented with an antimuscarinic toxidrome due to benztropine and risperidone ingestion. His delirium was prolonged and difficult to treat with benzodiazepines. Multiple doses of physostigmine successfully treated it. Benztropine is a potent antimuscarinic agent, whereas risperidone has not been reported to cause antimuscarinic toxicity. The use of physostigmine to treat benztropine intoxication in a pediatric patient has not previously been described. In this case, multiple doses were used and were well tolerated.
ISSN:1535-1815
DOI:10.1097/PEC.0000000000000503