Identification and Treatment of Acute Psychotic States Secondary to the Usage of Over-the-Counter Sleeping Preparations

Within eight months, 36 patients seen at the Washington Hospital Center, Washington, D.C., presented the problem of differentiating between a toxic psychosis caused by ingestion of over-the-counter sleeping medications containing scopolamine and a schizophrenic episode. Clinical evaluations, case histories, and thin-layer chromatography were used to identify these patients. Urinalysis revealed the presence of at least two ingredients of over-the-counter sleeping medications in ten patients. Intramuscular injections of physostigmine salicylate reversed the toxic psychosis presumed to be the result of the scopolamine content in these preparations.