Neuroleptic-Induced Supersensitivity Psychosis

TLDR: The anticholinergic effects of chlorpromazine, amitriptyline, scopolamine (Sominex) (0), and tropicamide were probably additive and although her disorientation cleared rapidly, Ms. A maintained that her hallucinations persisted during her 2-week hospitalization.

Abstract: drops from neurologic disease, pilocarpine, a parasympathomimetic agent, is safe and reliable. It causes ·constriction of the iris sphincter unless atropine or an·other postsynaptic blocker, such as tropicamide, the substance involved in this case, has been used. Physostigmine salicylate (Antilirium) was not used, · but it is effective in treating anticholinergic intoxica.' tion when administered intramuscularly (l mg repeated in 15-20 minutes if necessary). In Ms. A's case, the anticholinergic effects of chlorpromazine, amitriptyline, scopolamine (Sominex) (0), and tropicamide were probably additive. Although her disorientation cleared rapidly, Ms. A maintained that her hallucinations persisted during her 2-week hospitalization. However, it is difficult to know : whether this was actually the case. Given the previous diagnosis of Munch~lUsen syndrome and her unusual willingness to assume the psychiatric patient role as well as the medical-surgical patient role, it is not unlikely that she was attempting to prolong her hospitalization.