Moreau A, Jones B D, Banno V
Can J Psychiatry. 1986 May;31(4):339-41. doi: 10.1177/070674378603100411.
Acute anticholinergic delirium has been reported to occur following ingestion of antidepressants, neuroleptics and antiparkinsonian drugs in toxic and therapeutic doses. A case is described of a chronic central anticholinergic syndrome in a patient receiving a combination of such drugs. This chronic anticholinergic toxicity was superimposed on manic depressive illness which resulted in incorrect diagnoses including schizophrenia and dementia and, accordingly, improper management. Diagnosis of central anticholinergic toxicity may be overlooked in psychiatric patients because the symptoms of toxicity can be incorrectly ascribed to psychiatric illness. It may also be overlooked in elderly patients who are prone to demonstrate confusion and problems with memory. The recognition of this syndrome in the patient reported, at least nine years after it developed, led to appropriate management which ultimately resulted in a dramatic change in her ability to function.
据报道，摄入中毒剂量和治疗剂量的抗抑郁药、抗精神病药和抗帕金森病药物后会发生急性抗胆碱能谵妄。本文描述了一例接受此类药物联合治疗的患者出现慢性中枢抗胆碱能综合征的病例。这种慢性抗胆碱能毒性叠加在躁狂抑郁症之上，导致了包括精神分裂症和痴呆症在内的错误诊断，以及相应的不当治疗。中枢抗胆碱能毒性的诊断在精神科患者中可能被忽视，因为毒性症状可能被错误地归因于精神疾病。在容易出现意识模糊和记忆问题的老年患者中也可能被忽视。在本文报道的患者中，该综合征至少在出现九年后才被识别出来，随后进行了适当的治疗，最终使她的功能能力发生了巨大变化。
