[Acute atropinic syndrome caused by abuse of anti-asthmatic cigarettes (Datura stramonium)].

Over a 3-month period four patients (3 males and 1 female) aged 17 to 23 were admitted to an emergency unit with an acute anticholinergic syndrome. All of them had ingested aniasthmatic cigarettes containing Datura stramonium leaves for psychedelic purposes. The clinical features were characterized by striking peripheral signs of anticholinergic inhibition associated with central nervous system manifestations such with central state, hallucinations and abnormal behaviour. One patient had to be treated with physostigmine salicylate. The other three received supportive care only. The central and peripheral symptomatology subsided gradually over 12-48 hours. All four patients had more or less extensive amnesia regarding the acute toxic phase. Based on these observations, the possible causes, differential diagnosis and treatment of acute atropinic intoxication are reviewed. The discussion also considers the problem of abuse of "over-the-counter" atropine containing preparations.