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March 1973

More About Acute Psychotic Reactions to Aqueous Procaine Penicillin G

Arch Dermatol. 1973;107(3):468. doi:10.1001/archderm.1973.01620180106046

To the Editor.—  We read with interest the "Acute Psychotic Reactions to Aqueous Procaine Penicillin G" by Dr. Milton S. Ross (Arch Dermatol 106:599, 1972) in which he commented about this "psychotic" reaction being more than coincidence in black males and that no clear-cut reactions have been noted in women, black or white. It is of interest that some of the reactions have been very severe and difficult to control.We have recently reviewed 14 cases of this nonallergic adverse reaction to aqueous procaine penicillin G (APPG) which have occurred in patients during an 18-month period at the Detroit Social Hygiene Clinic. Incidence was 0.1%. These pseudoanaphylactic reactions superficially resemble anaphylactic reactions.1 Twelve reactions occurred in black males and two reactions were in black females (one patient received 4.8 mg units and the rest received 2.4 mg units). Recently, another patient, a 27-year-old white man had a severe

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