Promethazine-induced delirium with perceptual abnormalities: are we thinking broadly when assessing patients?

BMJ Case Rep. 2021 Apr 15;14(4):e241784. doi: 10.1136/bcr-2021-241784.

Abstract

There is limited information about promethazine-induced delirium with psychotic symptoms. The aim is to highlight the importance of taking a detailed history including medication use/abuse of both prescribed, illicit and over-the-counter preparations. This paper describes a patient who presented with delirium in the context of overuse of promethazine (Phenergan) which was initially missed. The patient was treated successfully, following the diagnosis of promethazine-induced delirium. Clinicians should be aware of assessing patients presenting with delirium to explore the possibility of over-the-counter medication misuse.

Keywords: drug misuse (including addiction); drugs and medicines; psychiatry (drugs and medicines); toxicology; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Delirium* / chemically induced
  • Delirium* / diagnosis
  • Humans
  • Nonprescription Drugs / adverse effects
  • Promethazine / adverse effects
  • Substance-Related Disorders*

Substances

  • Nonprescription Drugs
  • Promethazine