Delirium Following Oral Single-Dose Biperiden

Abstract

Anticholinergic drug use is one known cause of delirium. Biperiden which is an anticholinergic drug is shown to cause delirium in experimental studies and some case reports. But these reports shows great amount of biperiden use or parenteral therapy. In this case we report a patient developing delirium following a single oral dose of 2 mg biperiden. Although the pathophysiology of delirium is uncertain, we think that the cause of delirium in this patient was biperiden blocking the M1 receptors in the cerebral cortex and striatum.

Keywords

• Anticholinergic,biperiden,delirium

References

1. Wilber ST, Ondrejka JE. Altered Mental Status and Delirium. Emerg Med Clin North Am. 2016;34(3):649-65.
2. Rojo-Sanchis AM, Velez-Diaz-Pallares M, Munoz Garcia M, Delgado Silveira E, Bermejo Vicedo T, Cruz Jentoft A. Anticholinergic burden and delirium in elderly patients during acute hospital admission. Rev Esp Geriatr Gerontol. 2016;51(4):217-20.
3. Tamura Y, Chiba S, Takasaki H, Tabata K, Ishimaru Y, Ishimoto T. Biperiden-induced delirium model in rats: a behavioral and electroencephalographic study. Brain Res. 2006;1115(1):194-9.
4. Hewer W, Biedert S. Delirium syndrome in biperiden poisoning. Fortschr Neurol Psychiatr. 1988;56(4):133-6.
5. Espi Martinez F, Espi Forcen F, Shapov A, Martinez Moya A. Biperiden Dependence: Case Report and Literature Review. Case Reports in Psychiatry. 2012;2012:3.