Rivastigmine to Prevent Recurrence of Antimuscarinic Delirium

Summary

Antimuscarinic delirium (AMD) is a common and dangerous toxicology condition caused by poisoning by medications and other chemicals that block muscarinic receptors. Physostigmine is effective in reversing AMD but has a short duration of action, and patient commonly experience recurrence of AMD after initial control with physostigmine. Recent case reports and small observational studies suggest that rivastigmine, which has a longer duration of action than physostigmine, might be useful in the treatment of AMD. In order to investigate the effectiveness of rivastigmine in preventing recurrence of AMD after initial control with physostigmine, the investigators propose a randomized, placebo-controlled clinical trial of rivastigmine for AMD. The investigators hypothesize that patients treated with rivastigmine after initial control of AMD with physostigmine will experience less recurrence of antimuscarinic delirium than those treated with placebo.

Timeline

Start

2024-11-04

Primary completion

2028-11

Completion

2028-12

Outcome

Outcome not reported

Stopped: “Physostigmine (standard of care treatment under this protocol) became unavailable at the study site June 1st 2026, requiring suspension of the study.”

Drugs

Indications