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INNOSC Theranostics and
Pharmacological Sciences Atropine-induced psychosis in organophosphate poisoning

poisoning compared to other OP insecticides, with a case monitoring and individualized treatment approaches.
fatality rate of 6.5%. Notably, while most patients presented Understanding adverse drug reactions, pathophysiological
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fully alert, a minority exhibited impaired consciousness. mechanisms, and pre-disposing factors are critical in
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This variability in clinical presentation underscores the managing this complex clinical condition. Continued
need for individualized treatment approaches based on the research efforts are warranted to further elucidate its
severity of poisoning. underlying mechanisms and optimize treatment outcomes,
Atropine’s potent pharmacological effects make ultimately improving patient care and safety.
it widely used in the management of OP poisoning. Acknowledgments
However, adverse effects, including psychosis, can occur,
necessitating prompt recognition and intervention. The None.
diagnosis of atropine-induced psychosis aligns with the
DSM-IV-TR criteria, with patients often meeting at least Funding
three of the four criteria for drug-induced psychosis. None.
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Management strategies involve discontinuing the causative
agent, adjusting the dose, and providing symptomatic Conflict of interest
treatment.
Dr. Mohammed Misbah Ul Haq is an Editorial Board
In cases of atropine-induced psychosis, discontinuation Member of this journal, but was not in any way involved
of atropine and substitution with alternative muscarinic in the editorial and peer-review process conducted for
agents such as physostigmine, glycopyrrolate, or this paper, directly or indirectly. Separately, other authors
scopolamine have been effective in alleviating psychotic declared that they have no known competing financial
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symptoms. In addition, antipsychotics, such as interests or personal relationships that could have
haloperidol and benzodiazepines, such as diazepam or influenced the work reported in this paper.
lorazepam, are viable treatment options. It is crucial to
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note that adverse drug reactions can occur with atropine Author contributions
therapy, particularly when administered intravenously, Conceptualization: All authors
emphasizing the importance of vigilant dose management Formal analysis: All authors
and early cessation of the offending drug to prevent further Investigation: All authors
complications. 4 Writing-original draft: All authors

Recent advancements in understanding atropine- Writing-review and editing: All authors
induced psychosis have elucidated its pathophysiological
mechanisms and pre-disposing factors. Hypotheses Ethics approval and consent to participate
regarding the underlying mechanisms include disruption This case report is exempt from institutional review. Per
of central cholinergic neurotransmission, altered our institutional guidelines, case reports of three or fewer
dopaminergic signaling, and modulation of glutamatergic patients do not require institutional review board approval.
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and GABAergic pathways. Pre-disposing factors such Verbal consent was obtained from the patient.
as advanced age, pre-existing psychiatric disorders,
substance abuse, polypharmacy, and underlying medical Consent for publication
comorbidities increase susceptibility to atropine-
induced psychosis. Moreover, the concomitant use Verbal consent to publish his data was obtained from the
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of other medications with anticholinergic properties, patient.
such as antipsychotics, antidepressants, antihistamines, Availability of data
and antiparkinsonian agents, may potentiate the risk of
psychosis. Close monitoring and comprehensive clinical The datasets used and/or analyzed during the current
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assessment are essential for accurate diagnosis and timely study are available from the corresponding author upon
intervention. reasonable request.
4. Conclusion References

Atropine-induced psychosis remains a rare but potentially 1. Eddleston M, Buckley NA, Eyer P, Dawson AH. Management
serious complication in the management of OP poisoning. of acute organophosphorus pesticide poisoning. Lancet.
Recent case studies provide insights into its occurrence and 2008;371(9612):597-607.
management strategies, emphasizing the need for vigilant doi: 10.1016/S0140-6736(07)61202-1

Volume 7 Issue 4 (2024) 4 doi: 10.36922/itps.4607