Theophylline Acute psychosis in an asthmatic child: case report

A 5-year-old asthmatic boy was admitted after developing sleeplessness and disorientation lasting several days since learning of his great-grandmother's death . He had been receiving oral theophylline 250mg in the morning and at night and 185mg at midday. Serum theophylline was 48 mg/L (moderately toxic); EEG and CT scan of the head were normal.

The child was distraught, talked about death, refused to eat, began to pick at himself and was orientated only to person. Two doses of 1M haloperidol 1 mg were given, and after a 36-hour period of somnolence the patient again exhibited flight of ideas. By day 7 postadmission the theophylline level was 2.5 mg/L and the patient was transferred to a psychiatric hospital. Symptoms resolved by day 23 of psychiatric hospitalisation and no further psychotic episodes developed during the following 2.5 years. The child was maintained on oral theophylline, 300mg in the morning and 200mg at night. Manstein P A case of acute psychosIs In temporal association with theophylline toxicity Journal of Clinical Psychopharmacology 9- 65-66. Feb t989 ... ,