Antagonistic Effects of Scopolamine and Atropine on the Physostigmine Response in Man

A series of preclinical studies suggest that scopolamine may be a better antidote for centrally acting cholinesterase inhibitor toxicity than is atropine. The current experiment was designed to compare the antagonistic effects on centrally mediated cholinergic symptoms in man of scopolamine and atropine, using noncentrally acting methscopolamine as a reference compound. Scopolamine, but not atropine, significantly antagonized physostigmine's behavioral, neuroendocrine, and cardiovascular effects. Scopolamine may thus be a preferred treatment for centrally mediated cholinesterase inhibitor-induced symptoms.