The authors reported a case of toxic delirium due to Benztropine medication.
The case was a 24 years old Korean male who had been treated by 15mg of Trifluoperazine under the diagnosis of acute paranoid schizophrenia. Benztropine 2mg was given for control of his extrapyramidal symptom: rigidity of extremities and face. Toxic delirium with fear, agitation, disorientation, visual and tactile hallucination of small insects, auditory hallucination and psychomotor ex(:itement developed 5 days after Benztropine medication. The above symptoms always aggravated at night. Prodromal symptoms such as uncontrollable insomnia and agitation as well as mild fever and increased pulse rate could be evaluated even at the first night of Benztropine medication. Toxic deUrious symptoms disappeared within 5 days after discontinuation. On the third day after disappearance of the symptoms, Benztropine 4mg was given for the purpose of confirming cause of the delirium. Similar symptoms of the previous delirium developed one day after remedication. This delirium subsided on the day of discontinuation.
Discussion was focussed on the clinical problem such as incidence of Benztropine delirium, dosage and duration of medication, course and prognosis with reference to the previous articles. The authors, main findings are as follows. Minimal or usual dosage of Benztropine can result in toxic delirium, whereas prodromal symptoms of Benztropine delirium are uncontrollable insomnia, agitation, mild fever and increased pulse rate.
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