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August 26, 1974

Physostigmine Reversal Of Sedative Drugs

Author Affiliations

New England Medical Center Boston

JAMA. 1974;229(9):1168. doi:10.1001/jama.1974.03230470020010

To the Editor.—  Physostigmine is an effective antidote to the central effects of scopolamine and a variety of other drugs that may have anticholinergic activity, eg, tricyclic antidepressants and antihistamines.1Animal studies have suggested that physostigmine will reverse sedation from the butyrophenone haloperidol.2 In man, there are indications of its usefulness in antagonizing phenothiazine- and diazepam-induced coma.3The following case history describes the use of physostigmine in the reversal of sedation from the butyrophenone droperidol and diazepam without effecting narcotic analgesia.

Report of a Case.—  A healthy, but extremely anxious, 37-year-old man was scheduled to undergo right inguinal hernia repair. He was premedicated with morphine sulfate, 12 mg, diazepam, 10 mg, and atropine, 0.4 mg, one hour prior to surgery. In the operating room he was alert and cooperative but quite apprehensive. Anesthesia was induced with diazepam, 20 mg, and 5 ml of a mixture of droperidol