title: Immediate nonallergic psychotic reaction to intramuscular procaine penicillin.
abstract: BACKGROUND
  Though little known by medical personnel, an immediate nonallergic psychotic reaction to intramuscular procaine penicillin has been reported occasionally from many countries since 1951.
  
  
  METHODS
  A case report describes a patient whose violent behavior, provoked by this reaction, resulted in legal action taken against him. Two other nonviolent cases are presented and are followed by a review of the literature.
  
  
  RESULTS
  Signs and symptoms of this reaction that appears to be to the procaine component resemble a pressor response and are therefore contrary to the signs and symptoms of an anaphylactic reaction. Anxiety, hallucinations, hypertension, and tachycardia are characteristic. The reaction is self-limited. Long-term psychologic sequelae might be averted by adequate reassurance.
  
  
  CONCLUSIONS
  The importance of procaine penicillin as an essential drug in many parts of the world should not be diminished; however, recognition of acute nonallergic psychotic reactions is of paramount importance to assure proper patient management and to avoid misinterpretation of aggressive behavior.
authors.affiliation: Hôpital d'Arrondissement, Kolofata, Cameroun.
authors.forename: E M
authors.initials: EM
authors.lastname: Einterz
authors.forename: R M
authors.initials: RM
authors.lastname: Einterz
mesh_terms: D000368:Aged; D002648:Child; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D010402:Penicillin G Procaine / Q000008:administration & dosage / Q000009:adverse effects*; D011605:Psychoses, Substance-Induced / Q000209:etiology*
chemical_list: D010402:Penicillin G Procaine