Actively Recruiting
Rivastigmine to Prevent Recurrence of Antimuscarinic Delirium
Led by Washington University School of Medicine · Updated on 2026-04-21
42
Participants Needed
1
Research Sites
103 weeks
Total Duration
On this page
Sponsors
W
Washington University School of Medicine
Lead Sponsor
A
American Academy of Clinical Toxicology
Collaborating Sponsor
AI-Summary
What this Trial Is About
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.
CONDITIONS
Official Title
Rivastigmine to Prevent Recurrence of Antimuscarinic Delirium
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Participant is 10 years of age or older
- Diagnosed with antimuscarinic delirium by history and physical exam as judged by the treating toxicologist
- Physostigmine treatment is planned or has been given and accepted by the primary physician and surrogate decision maker
- Antimuscarinic delirium is reasonably controlled after initial physostigmine treatment as assessed by the treating toxicologist
You will not qualify if you...
- Age less than 10 years at enrollment
- No surrogate decision maker available to provide informed consent
- Patient is pregnant or a ward of the state
- Unable to safely take oral medication as judged by the treating physician
- High risk for serious cardiac or neurologic problems from antimuscarinic poisoning including known or suspected seizures, certain abnormal heart rhythms, respiratory failure requiring intubation, low blood pressure, or prior use of certain emergency medications
- High risk for adverse effects from acetylcholinesterase inhibitors including bradycardia, seizure disorders, asthma or COPD, physical obstruction of intestines or urinary tract (except ileus or urinary retention due to poisoning), or peptic ulcer disease
- Known allergy or intolerance to rivastigmine or other acetylcholinesterase inhibitors
- Failure to achieve reasonable initial control of antimuscarinic delirium after physostigmine administration
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
Washington University School of Medicine
St Louis, Missouri, United States, 63110
Actively Recruiting
Research Team
K
Kevin Baumgartner, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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