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Hugh H. Hussey, MD

JAMA. 1975;231(10):1066.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In the current issue of Archives of General Psychiatry (23:375-380, 1975), Granacher and Baldessarini note that a number of drugs that have anticholinergic action, in addition to provoking peripheral manifestations, can have serious toxic effects on the central nervous system, characterized by delirium, anxiety, hyperactivity, hallucinations, disorientation, and seizures. The list of drugs is long and includes antidepressants, antipsychotic drugs, antihistamines, antispasmodics, and antiparkinsonian agents.

Granacher and Baldessarini believe that too few psychiatrists are aware that administration of physostigmine salicylate parenterally is the specific treatment for the central toxic effects of anticholinergic agents. Although relief of peripheral effects can be attained by administering other cholinergic drugs, they have no action on the central toxic effects because they do not cross the blood-brain barrier, which is something physostigmine does easily.

To support their view on the value of physostigmine, the authors report four cases in which patients developed central anticholinergic toxic . . . [Full Text PDF of this Article]

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