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Mania Secondary to Procyclidine (‘Kemadrin’) Abuse

Published online by Cambridge University Press:  29 January 2018

Jeremy Coid
Affiliation:
The Bethlem Royal and Maudsley Hospital, Denmark Hill, London, SE5 8AZ
John Strang
Affiliation:
Manchester Drug Dependence Unit, Prestwich Hospital, Manchester, M25 7BL. Formerly Senior Registrar, Drug Dependence Clinical Research and Treatment Unit, The Bethlem Royal and Maudsley Hospital, London, SE5 8AZ

Summary

A case of procyclidine abuse is described in which the clinical presentation was indistinguishable from mania. The patient was a long-standing poly-drug abuser and was obtaining the drugs from medical sources. Controlled exposure on the ward to drugs of abuse, including a double-blind comparison with placebo, confirmed that procyclidine caused a manic response in this patient.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Bjorndal, N. & Frewald, B. (1977) Report of a case of pronounced addiction to procyclidine (Kemadrin). Ugeskrift for Laeger, 139/42, 2512–13.Google Scholar
Blackburn, I. M., London, J. B. & Ashworth, C. M. (1977) A new scale for measuring mania. Psychological Medicine, 7, 453–8.Google Scholar
Bolin, R. R. (1960) Psychiatric manifestation of Artane toxicity. Journal of Nervous and Mental Disease, 131, 256–9.Google Scholar
Carroll, B. J., Frazer, A., Schloss, D. A. et al (1973) Cholinergic reversal of manic symptoms. Lancet, i, 427–48.Google Scholar
Connell, P. H. (1958) Amphetamine Psychosis. Maudsley Monograph, No 5. Institute of Psychiatry. London: Chapman and Hall Google Scholar
Davis, K. L., Berger, P. A., Holliston, L. E. & Defraites, E. (1978) Physostigmine in mania. Archives of General Psychiatry, 35, 119–22.Google Scholar
Falloon, I., Watt, D. C. & Shepherd, M. (1978) A comparative controlled trial of primozide and schizophrenia: Fluphenazine decanoate in the continuation therapy of schizophrenia. Psychological Medicine, 8, 5970.Google Scholar
Janowsky, D. S., El-Yousef, M. K. & Davis, J. M. (1972) A cholinergic-adrenergic hypothesis of mania and depression. Lancet, ii, 632–5.Google Scholar
Janowsky, D. S., El-Yousef, M. K. & Davis, J. M. (1973) Parasympathetic suppression of manic symptoms by physostigmine. Archives of General Psychiatry, 28, 542–7.CrossRefGoogle ScholarPubMed
Johnson, D. A. W. (1981) Studies of depressive symptoms in schizophrenia, III. A double-blind trial of Orphenadrine against placebo. British Journal of Psychiatry, 139, 96–7.Google Scholar
Krauthammer, C. & Klerman, G. L. (1978) Secondary mania manic syndromes associated with antecedent physical illness or drugs. Archives of General Psychiatry, 35, 1333–9.Google Scholar
MacVicar, K. (1977) Abuse of anti-parkinsonian drugs by psychiatric patients. American Journal of Psychiatry, 134, 809–11.Google Scholar
Marriott, P. (1976) Dependence on anti-parkinsonian drugs. British Medical Journal, i, 152.Google Scholar
Meier, V. (1973) Intoxication with procyclidine hydrochloride (Kemadrin). Schweizischer Rundschau Medizin (Praxis), 62, 473–5.Google Scholar
Mohan, D., Mohandus, E. & Dube, S. (1981) Trihexyphenidyl abuse. British Journal of Addiction, 76, 195–7.Google Scholar
Rubinstein, J. S. (1978) Abuse of anticholinergic drugs. New England Journal of Medicine, 299, 834.Google Scholar
Shariatmadari, M. E. (1975) Orphenadrine dependence. British Medical Journal, iii, 486.Google Scholar
Slavney, P. R., Rich, G. B., Pearlson, G. D. & McHugh, P. R. (1977) Phencyclidine abuse and symptomatic mania. Biological Psychiatry, 12/5, 697700.Google Scholar
Van Putten, T. & May, P. R. A. (1978) Akinetic depression in schizophrenia. Archives of General Psychiatry, 124, 699702.Google Scholar
Woody, G. E. & O'Brien, C. P. (1974) Anticholinergic toxic psychosis in drug abusers treated with benztropine. Comprehensive Psychiatry, 15, 439–42.Google Scholar
Young, R. C., Biggs, J. T., Zicglar, V. E. & Meyer, P. A. (1978) A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133, 424–6.Google Scholar
Zier, A. & Doshay, L. J. (1957) Procyclidine hydrochloride (Kemadrin) treatment of parkinsonism: Result in 108 patients. Neurology, 00, 485–9.Google Scholar
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