Work

Physo’s back: A case report and brief review of the safety of physostigmine in the management of antimuscarinic delirium

Year: 2025

Type: article

Abstract: Antimuscarinic delirium is a commonly encountered condition. Physostigmine is an effective antidote with a well established safety profile, though use has waned following a supply shortage. Both antihistamines and atypical antipsychotics are frequently implicated in antimuscarinic delirium, and quetiapine in particular may cause prolonged symptoms. We present a case of delirium precipitated by quetiapine refractory to repeated physostigmine administration, highlighting both its safety of use and limitations. As physostigmine supply is renewed, clinicians should again become familiar with its applications, while acknowledging therapeutic limits and the necessity of adjuncts in the delivery of care in severe cases.

Source: Medical Reports

DOI: 10.1016/j.hmedic.2025.100282

Authors: William Bleifuss, Elizabeth DeYoung, Benjamin Willenbring, Sean Boley, Brad Hernandez

Institutions: Regions Hospital, United Hospital

Language: English

Topic: Intensive Care Unit Cognitive Disorders

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $1,900