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KMID : 1100220060050010018
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Dementia and Neurocognitive Disorders
2006 Volume.5 No. 1 p.18 ~ p.24
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Scopolamine Patch induced Mental Confusion in Elderly
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Seo Sang-Won
Yoon Soo-Jin
Na Duk-Lyul
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Abstract
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Background: Scopolamine is one of the popular regimens for the prophylaxis and treatment of the motion sickness. It has been reported that mental confusion can occur after application of transdermal scopolamine. However, no previous studies have documented the predisposing factors for mental confusion associated with scopolamine patch. We hypothesized that elderly people with subclinical mild cognitive impairment (MCI) may be prone to have developed mental confusion after applying scopolamine patch. Thus, we performed neuropsychogical tests in 6 elderly patients with scopolamine patch-induced mental confusion in the stage when they had recovered from mental confusion.
Methods: All the patients were female, and the age of them ranged from 65 to 82 years (median 72 years). They showed onset of abnormal behaviors such as disorientation, hallucination, sleep disturbance, repetitive behavior and restlessness at 9 average hours after the application of the scopolamine patch. Their symptoms mostly were disappeared after the removal of patch within several hours, but one patient had her symptoms for 2 days after the removal of the patch. All the patients were examined using detailed neuropsychological evaluations at 2 average months (range: 3 days- 4months) after onset of mental confusion.
Results: The neuropsychological tests revealed that all the patients were impaired in at least one of cognitive domains such as attention, confrontational naming, visual spatial, and frontal executive function. In our cases, these neuropsychological findings along with intact activities of daily living were fulfilled with the criteria of MCI.
Conclusions: Our results suggest that scopolamine patch-induced mental confusion can be included in the differential diagnoses of mental confusion in elderly, especially in travel situation, and that older people with subclinical MCI are prone to have developed scopolamine patch-induced mental confusion.
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KEYWORD
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Transdermal scopolamine patch, Mental confusion, Traveling, Mild cognitive impairment
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