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The Use of Atropine as a Sedative

Published online by Cambridge University Press:  19 February 2018

Extract

The high place assigned by Dr. Ringer to atropine as a sedative and hypnotic has lately suggested to me to try it in the cases which are so much relieved by hyoscyamine. My experience has so far been too limited to pronounce definitely on its value; but it may be sufficient to induce other observers with more ample opportunities to give it a trial, and come to some definite conclusion as to its value. I have given it only in three cases: two of chronic mania with considerable violence and destructiveness, and the third of chronic insanity, characterised by vivid terrifying auditory hallucinations, which caused constant screaming and excitement. All three had been previously treated with hyoscyamine, and with the result of greatly quieting them. Two have now been taking the atropine for three months, and one for two months, in doses I shall presently mention, with occasional intermissions to test the action of the remedy. Comparing its action with hyoscyamine, it seems to me that it is less powerful than that alkaloid. The patients are less completely subdued and helpless: there are occasional outbursts of violence and excitement, though by no means so great as when atropine is not taken. Its effects seem to pass off more quickly, so that it needs to be given two or three times in the twenty-four hours. On the other hand, the patients are decidedly in a more natural and healthy condition; there is less stupor, oppression, and heaviness than under hyoscyamine. The pupils need generally not be dilated, but there is often much dryness of throat before the dose is reached, which quiets the patient. I ordered a solution of atropine in glycerine, of the strength of the liquor atropiæ P.B., on account of the risks from evaporation of the officinal preparation. I began with m. ij of this in each case, and have now pushed it in two cases to m x, and in the third to m vj twice a day. One case I treated for a while with belladonna, giving 3j of the tincture; but the atropine seems more uniform and convenient, especially as it can be administered without the patient's knowledge if necessary. I may remark that hyoscyamine is about fifteen times the price of atropine, which would be a matter of some importance in a large practice, if the action of the two drugs is not very different. I regret that I have had no acute case in which the alkaloid might be suitably tried since its use occurred to me. It might be worth trying whether the persistent use of atropine in full doses might not be useful as a curative agent in chronic mania, as it has sometimes been found to cure that cognate neurosis, exophthalmic goitre.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1882 

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References

* “Journal of Mental Science,” July, 1870.Google Scholar
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