Improvement in delirium and visuospatial function after rivastigmine in antimuscarinic toxicity: a case report

Treatment of antimuscarinic toxicity has become more difficult in the United States due to an ongoing national shortage of physostigmine. Rivastigmine has emerged as an alternative, off-label therapy due to its similar mechanism of action as a reversible, centrally-acting acetylcholinesterase inhibi...

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Veröffentlicht in:Toxicology communications 2023-12, Vol.7 (1)
Hauptverfasser: Correia, Matthew S., Hendrickson, Robert G.
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Sprache:eng
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Zusammenfassung:Treatment of antimuscarinic toxicity has become more difficult in the United States due to an ongoing national shortage of physostigmine. Rivastigmine has emerged as an alternative, off-label therapy due to its similar mechanism of action as a reversible, centrally-acting acetylcholinesterase inhibitor. We present a case of a diphenhydramine overdose where the patient exhibited classic central antimuscarinic delirium characterized by inattention, floccillation, and deficits in spatial planning manifested by the inability to properly draw a clock. These symptoms rapidly resolved after treatment with oral rivastigmine.
ISSN:2473-4306
2473-4306
DOI:10.1080/24734306.2023.2253688