CLINICAL-EXPERIENCE IN ACUTE OVERDOSAGE OF DIPHENIDOL

Background: Diphenidol (Cephadol, Vontrol(R)), an antiemetic agent use d in the treatment of vomiting and vertigo, has been reported to cause various adverse effects including drowsiness, hypotension, confusion, hallucination, restlessness, and other antimuscarinic effects. Seriou s toxic effects might be anticipated after intentional off accidental ingestion. Materials and methods: Retrospective analysis of all case r ecords of the PCC-Taiwan defining diphenidol overdose during 1985-1996 . Results: The data of 21 patients with diphenidol overdose were analy zed; 17 were <3 years old and unintentionally poisoned, in contrast to the suicide attempts by four adults. The average amount of ingestion was 222.5 mg with a range of 25-800 mg. Most patients manifested only transient CNS, cardiovascular, or oculo-facial effects, but four child ren suffered from severe toxicity after an ingestion of 11.7-80 mg/kg diphenidol. Commonly reported toxicity in diphenidol overdose included facial flush (10), tachycardia, restlessness (6), seizures (4), dyspn ea, drowsiness, mydriasis, coma, and fever (3). With supportive therap y, a good recovery was the rule except for one fatality of a 21/2-year -old boy who ingested 15 mg/kg diphenidol and presented with recurrent seizures, hypotension, respiratory failure, and coma. Conclusions: Al though not previously reported, accidental diphenidol overdose may res ult in serious anticholinergic toxicity in children. Treatment is supp ortive and the therapeutic role of physostigmine in diphenidol poisoni ng is still unclear.