A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning

Study objective: To compare the efficacy and safety of physostigmine with benzodiazepines for the treatment of agitation and delirium associated with anticholinergic poisoning. Methods: We conducted a retrospective study of 52 consecutive patients referred to a university hospital toxicology consult...

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Bibliographic Details
Published in:Annals of emergency medicine 2000-04, Vol.35 (4), p.374-381
Main Authors: Burns, Michael J., Linden, Christopher H., Graudins, Andis, Brown, Robert M., Fletcher, Kenneth E.
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Akathisia, Drug-Induced - drug therapy
Benzodiazepines - administration & dosage
Benzodiazepines - therapeutic use
Biological and medical sciences
Central Nervous System - drug effects
Cholinergic Antagonists - blood
Cholinergic Antagonists - poisoning
Cholinesterase Inhibitors - administration & dosage
Cholinesterase Inhibitors - therapeutic use
Delirium - chemically induced
Delirium - drug therapy
Drug intoxications. Doping
Humans
Injections, Intramuscular
Injections, Intravenous
Medical sciences
Pharmacology. Drug treatments
Physostigmine - administration & dosage
Physostigmine - therapeutic use
Poisoning - drug therapy
Retrospective Studies
Tropical medicine
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Summary:Study objective: To compare the efficacy and safety of physostigmine with benzodiazepines for the treatment of agitation and delirium associated with anticholinergic poisoning. Methods: We conducted a retrospective study of 52 consecutive patients referred to a university hospital toxicology consultation service who were treated with physostigmine, benzo-diazepines, or both for anticholinergic agitation and delirium. Patients treated with physostigmine were compared with those treated with benzodiazepines with respect to demographics, severity of poisoning, response to treatment, side effects of treatment, and complications. Results: Physostigmine controlled agitation and reversed delirium in 96% and 87% of patients, respectively. Benzodiazepines controlled agitation in 24% of patients but were ineffective in reversing delirium. Initial treatment with physostigmine (n=30) resulted in a significant decrease in the incidence of agitation ( P
ISSN:0196-0644
1097-6760
DOI:10.1016/S0196-0644(00)70057-6