Bozkurt Muge, Karabulut Vahap, Evren Cuneyt, Seker Merve, Kan Hicret
a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey .
Subst Abus. 2015;36(2):170-3. doi: 10.1080/08897077.2014.924465. Epub 2014 Jun 3.
Tropicamide is an antimuscarinic ophthalmic solution used to produce short-acting mydriasis and cycloplegia. Topical abuse of ophthalmic solutions has been reported, but intravenous (IV) abuse of tropicamide seems to be a new phenomenon.
The authors present 2 patients with concomitant IV tropicamide abuse and opioid use disorder. Patients were hospitalized and started on buprenorphine/naloxone treatment for opioid withdrawal. Patients' reports about tropicamide effects are remarkable, as they claimed that tropicamide increased the efficacy of heroin while decreasing and delaying the withdrawal symptoms.
Although anticholinergics have been known to be abused for their euphoric effects, these cases' motivation to use tropicamide seemed to extend beyond its euphoric effect and was also based on its interaction with heroin. It is feared that tropicamide abuse may become more frequent. Health professionals should be aware of this trend so that symptoms of misuse and intoxication can be recognized, and ophthalmologists should consider the abuse potential of anticholinergic eye drops when prescribing them.
托吡卡胺是一种抗胆碱能眼药水，用于产生短效散瞳和睫状肌麻痹作用。已有关于眼药水局部滥用的报道，但静脉注射（IV）滥用托吡卡胺似乎是一种新现象。
作者介绍了2例同时存在静脉注射托吡卡胺滥用和阿片类药物使用障碍的患者。患者住院并开始接受丁丙诺啡/纳洛酮治疗以戒除阿片类药物。患者关于托吡卡胺作用的报告值得关注，因为他们声称托吡卡胺提高了海洛因的效果，同时减轻并延迟了戒断症状。
尽管已知抗胆碱能药物因其欣快作用而被滥用，但这些病例使用托吡卡胺的动机似乎超出了其欣快作用，还基于其与海洛因的相互作用。人们担心托吡卡胺滥用可能会变得更加频繁。卫生专业人员应意识到这一趋势，以便能够识别滥用和中毒症状，眼科医生在开抗胆碱能眼药水时应考虑其滥用可能性。
