Analysis of Atropine Induced Psychosis in Substance Abuse Patients

Park, Jun Hong; Park, Yong Jin; Kim, Sun Pyo; Cho, Soo Hyung; Kim, Seong Jung; Cho, Nam Soo

Abstract

PURPOSE: This study investigated the clinical characteristics and contributing factors of atropine induced psychosis for substance abuse patients who required atropine administration.
METHODS
This study retrospectively reviewed the medical records of substance abuse patients after required atropine administration at Chosun University Hospital emergency center from January 2001 through December 2004. The studied compared vital signs, arterial blood gas analysis(ABGA), amount and type of ingestions, underlying disease, transfer, and also the administered amount and velocity of atropine after administration. Additional comparisons were made of the revealed symptom time, duration of recovery and the administered amount and velocity of atropine.
RESULTS
Twenty-seven of fifty-one patients experienced atropine induced psychosis. Twenty-two subjects had abused organophosphate insecticides, two abused carbamate and the remaining three abused miscellaneous other chemicals. Of these patients, the average psychosis symptom was 53.3 hours and the average amount of administered atropine was 292.4 mg. because the amount and duration of atropine administration was reduced in these patients. Potential influencing factors of atropine induced psychoses included systolic BP(p=0.008) and gender(p=0.034).
CONCLUSIONS
Atropine induced psychosis has a high morbidity in substance abuse patients. The influencing factors of atropine induced psychosis include systolic BP and gender. These results suggest that consideration of influencing factors may be helpful to avoid atropine induced psychosis in patients with substance abuse.