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December 15, 1951


Author Affiliations

Toronto, Canada

From the Department of Medicine, University of Toronto, and the Medical Service of the Toronto General Hospital (Dr. Barnett and Dr. Spaulding), and the Department of Psychiatry, University of Toronto, and the Toronto Psychiatric Hospital (Dr. Jackson).

JAMA. 1951;147(16):1554-1558. doi:10.1001/jama.1951.73670330001012

This is a presentation of seven cases of thiocyanate psychosis, two of which were fatal, one having been studied at autopsy. An additional case of combined bromide and thiocyanate intoxication is described. The literature has been reviewed with regard to the toxicity of thiocyanate in the treatment of hypertension; in particular, reports of fatal cases have been examined.

During the last half-century medical observers have argued for and against the use of thiocyanate. From a perusal of the voluminous literature that has accumulated only two things seem firmly established: 1. Its effectiveness, either as a symptomatic remedy or as a drug useful in reducing blood pressure, is by no means generally accepted. 2. Toxic manifestations are relatively common.

Having fallen into disrepute about 25 years ago, thiocyanate came into favor again in 1936 when Barker1 described a rapid and easy chemical method of following the blood level accurately. He