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Psychotropics in Your Medicine Cabinet: A Case Study of Dimenhydrinate Use.
J Addict Med. 2019 Sep/Oct; 13(5):412-414.JA

Abstract

: Reporting of intoxication and withdrawal from aberrant use of over-the-counter medication has been sparse and inconsistent in literature. Attributed to their anticholinergic properties, medications such as dimenhydrinate (Gravol) taken in supratherapeutic doses have been associated with euphoria, anxiolysis, and hallucinations. We present a case of a woman in her forties, with a psychiatric history of bipolar disorder, and complex concurrent medical history including familial Mediterranean fever (FMF), and fibromyalgia, admitted for withdrawal management of her intravenous dimenhydrinate use. As a result of her FMF, there were numerous hospital admissions and treatment which required intravenous access. Hence, a physician-inserted intravenous access port was placed on her chest. The port was maintained monthly with the help of a community agency. In this port, she was injecting 100 to 200 mg of dimenhydrinate hourly for its euphoric and calming effects, consuming upwards of 2400 mg/d. Comprehensive laboratory work-up and urine drug screening were unremarkable. Vital signs were stable. Her mental status at time of admission was lethargic, unfocused, but calm. Her withdrawal symptoms included severe nausea, vomiting, sedation, headaches, dizziness, anxiety, and muscle stiffness. Her detoxification was managed with benztropine and lorazepam, and was well tolerated. The patient was discharged to a community inpatient rehabilitation center. Urine drug testing before discharge was negative. This case draws attention to the addictive potential of dimenhydrinate and offers a regime for its medical withdrawal management. Additionally, this case highlights that screening and management of over-the-counter medications warrants further clinical consideration and investigation.

Authors+Show Affiliations

University of Toronto, Faculty of Medicine (XW); Centre of Addiction and Mental Health, Addictions Division (FDP, NC); University of Toronto, Department of Family & Community Medicine (FDP); University of Toronto, Department of Psychiatry, Ontario, Canada (NC).No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30844875

Citation

Wen, Xia, et al. "Psychotropics in Your Medicine Cabinet: a Case Study of Dimenhydrinate Use." Journal of Addiction Medicine, vol. 13, no. 5, 2019, pp. 412-414.
Wen X, Di Paola F, Chopra N. Psychotropics in Your Medicine Cabinet: A Case Study of Dimenhydrinate Use. J Addict Med. 2019;13(5):412-414.
Wen, X., Di Paola, F., & Chopra, N. (2019). Psychotropics in Your Medicine Cabinet: A Case Study of Dimenhydrinate Use. Journal of Addiction Medicine, 13(5), 412-414. https://doi.org/10.1097/ADM.0000000000000511
Wen X, Di Paola F, Chopra N. Psychotropics in Your Medicine Cabinet: a Case Study of Dimenhydrinate Use. J Addict Med. 2019 Sep/Oct;13(5):412-414. PubMed PMID: 30844875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychotropics in Your Medicine Cabinet: A Case Study of Dimenhydrinate Use. AU - Wen,Xia, AU - Di Paola,Francesca, AU - Chopra,Nitin, PY - 2019/3/8/pubmed PY - 2020/7/30/medline PY - 2019/3/8/entrez SP - 412 EP - 414 JF - Journal of addiction medicine JO - J Addict Med VL - 13 IS - 5 N2 - : Reporting of intoxication and withdrawal from aberrant use of over-the-counter medication has been sparse and inconsistent in literature. Attributed to their anticholinergic properties, medications such as dimenhydrinate (Gravol) taken in supratherapeutic doses have been associated with euphoria, anxiolysis, and hallucinations. We present a case of a woman in her forties, with a psychiatric history of bipolar disorder, and complex concurrent medical history including familial Mediterranean fever (FMF), and fibromyalgia, admitted for withdrawal management of her intravenous dimenhydrinate use. As a result of her FMF, there were numerous hospital admissions and treatment which required intravenous access. Hence, a physician-inserted intravenous access port was placed on her chest. The port was maintained monthly with the help of a community agency. In this port, she was injecting 100 to 200 mg of dimenhydrinate hourly for its euphoric and calming effects, consuming upwards of 2400 mg/d. Comprehensive laboratory work-up and urine drug screening were unremarkable. Vital signs were stable. Her mental status at time of admission was lethargic, unfocused, but calm. Her withdrawal symptoms included severe nausea, vomiting, sedation, headaches, dizziness, anxiety, and muscle stiffness. Her detoxification was managed with benztropine and lorazepam, and was well tolerated. The patient was discharged to a community inpatient rehabilitation center. Urine drug testing before discharge was negative. This case draws attention to the addictive potential of dimenhydrinate and offers a regime for its medical withdrawal management. Additionally, this case highlights that screening and management of over-the-counter medications warrants further clinical consideration and investigation. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/30844875/Psychotropics_in_Your_Medicine_Cabinet:_A_Case_Study_of_Dimenhydrinate_Use L2 - https://doi.org/10.1097/ADM.0000000000000511 DB - PRIME DP - Unbound Medicine ER -