DOI: 10.21276/sasjm.2017.3.12.5

Pages: 335-338

Psychotropic medication overdoses are common, but patients are frequently unwilling or unable to identify their ingestant(s). We describe a case of a woman who developed antimuscarinic toxicity after ingesting quetiapine. Once her delirium was successfully treated with physostigmine, she was able to report co-ingesting valproic acid, for which she required hospital admission and antidotal therapy with L-carnitine. We recommend that, unless contraindicated, physostigmine should be administered in cases of moderate-to-severe antimuscarinic poisoning, both to treat the delirium and peripheral manifestations and as a diagnostic aid to obtain a more complete history