Pesticide-like Poisoning from a Prescription Drug

Abstract

To the Editor: Acetylcholinesterase inhibitors have long been known for their use as pesticides. Since the 1990s, acetylcholinesterase-inhibiting pharmaceuticals (donepezil, tacrine, galantamine, and rivastigmine) have been used to treat Alzheimer's disease; they are currently being investigated as a treatment for dementia associated with Parkinson's disease in adults1 and with Tourette's syndrome and autistic and attention deficit–hyperactivity disorders in children.2,3 Wider use of this class of medications for a broader variety of disorders increases the possibility of pesticide-like poisoning from a prescribed medication. We report a case of such poisoning. A healthy 11-month-old girl (weight, 7.5 kg) presented to a . . .