Bromism

Classification according to ICD-10
F13	Mental and behavioral disorders caused by sedatives or hypnotics
G92	Toxic encephalopathy
T42	Poisoning from anti-epileptic drugs, sedatives, hypnotics and anti-Parkinson drugs
ICD-10 online (WHO version 2019)

Bromism is the name of a syndrome that results from prolonged use of bromides such as carbromal or lithium bromide .

history

Bromism used to be very common and accounted for about 5 to 10% of psychiatric hospital admissions. Since the abandonment of bromide-containing active ingredients in drugs, beginning in the mid-1980s, after these became prescription-only in 1978, the poisoning decreased rapidly, whereby the clinical picture was increasingly forgotten. There were similar addiction problems with other sedatives (e.g. barbiturates , benzodiazepines ).

Symptoms

Bromine acne

High doses of bromides disrupt the membranes of neurons, which can lead to somnolence , psychosis and seizures .

The neurological and psychiatric symptoms are variable. This can lead to hyperexcitability , irritation, ataxia , tremor , drowsiness, hallucinations , psychosis , weakness, stupor and coma . In addition, gastrointestinal symptoms such as vomiting and loss of appetite and skin symptoms such as "bromine acne ", abscesses and erythema can occur.

diagnosis

The diagnosis is made by the detection of high levels of bromides in the blood or urine. In addition, with bromism the electrolyte, glucose and creatinine values are often disturbed. An X-ray of the abdomen can be helpful because of the radiopacity of bromine.

therapy

There are no known specific antidotes for bromide poisoning; However, the administration of chloride or fluoride can help the body to remove the bromine from the body more quickly. Furosemide can help patients with renal complications or severe bromism.

Individual evidence

^ Bromism. In: Deutsches Ärzteblatt. 91, issue 49, December 9, 1994, p. A3444.
↑ Hans Bangen: History of the drug therapy of schizophrenia. Berlin 1992, ISBN 3-927408-82-4 , p. 22.
↑ ^a ^b ^c ^d ^e Kent R. Olson: Poisoning & drug overdose . 4th edition. Appleton & Lange, 2003, ISBN 0-8385-8172-2 , pp. 140-141 ( google.co.uk ).
^ Marc Galanter, Herbert D. Kleber: The American Psychiatric Publishing Textbook of Substance Abuse Treatment . 4th edition. American Psychiatric Publishing, Washington et al. 2008, ISBN 978-1-58562-276-4 , pp. 217 ( google.co.uk ).
↑ The online encyclopedia of dermatology, venereology, allergology and environmental medicine : abscesses & erythema; Acne, bromine acne
↑ M. Lewandowsky: Practical neurology for doctors. (= Specialist books for doctors. Volume 1). Springer-Verlag, 2013, ISBN 978-3-642-99259-9 , p. 17. (online)

[1] Bromism. In: Deutsches Ärzteblatt. 91, issue 49, December 9, 1994, p. A3444.

[2] Hans Bangen: History of the drug therapy of schizophrenia. Berlin 1992, ISBN 3-927408-82-4 , p. 22.

[pdo2003-3] Kent R. Olson: Poisoning & drug overdose . 4th edition. Appleton & Lange, 2003, ISBN 0-8385-8172-2 , pp. 140-141 ( google.co.uk ).

[4] Marc Galanter, Herbert D. Kleber: The American Psychiatric Publishing Textbook of Substance Abuse Treatment . 4th edition. American Psychiatric Publishing, Washington et al. 2008, ISBN 978-1-58562-276-4 , pp. 217 ( google.co.uk ).

[5] The online encyclopedia of dermatology, venereology, allergology and environmental medicine : abscesses & erythema; Acne, bromine acne

[6] M. Lewandowsky: Practical neurology for doctors. (= Specialist books for doctors. Volume 1). Springer-Verlag, 2013, ISBN 978-3-642-99259-9 , p. 17. (online)