title: Prolonged Antimuscarinic Delirium in a Child Due to Benztropine Exposure Treated With Multiple Doses of Physostigmine.
abstract: 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.
authors.affiliation: From the *Poison Control Center, University of Kansas Hospital, Kansas City, KS; †Department of Medicine/Pediatrics, and ‡Division of Medical Toxicology, Department of Emergency Medicine, University of California San Diego, San Diego, CA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Thornton
authors.forename: Lauge
authors.initials: L
authors.lastname: Farnaes
authors.forename: Alicia
authors.initials: A
authors.lastname: Minns
mesh_terms: D001590:Benztropine / Q000009:adverse effects*; D002648:Child; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D003693:Delirium / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D010830:Physostigmine / Q000008:administration & dosage*
chemical_list: D002800:Cholinesterase Inhibitors; D018727:Muscarinic Antagonists; D001590:Benztropine; D010830:Physostigmine