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January 8, 1968, Vol 203, No. 2 >
ARTICLE | January 8, 1968

Delirium From Digitalis Toxicity

Henry J. L. Marriott, MD
JAMA. 1968;203(2):156. doi:10.1001/jama.1968.03140020084029.
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To the Editor:—  I have read "Delirium in a Coronary Care Unit" by Drs. Parker and Hodge (201:702, 1967) with interest, but also with disapproval because of an important and potentially dangerous oversight. The relevant facts are:

  1. Some of the country's leading coronary caretakers are openly recommending the almost routine digitalization of patients with acute myocardial infarction.

  2. Digitalis is a potent and not rare cause of delirium, which may occur in 3% or 4% of patients intoxicated with the drug.1

  3. Lethargy, which in the Parker and Hodge series was "frequently associated" with the symptoms of disorientation, is another not uncommon manifestation of digitalis toxicity, especially in bedfast patients.

The patients reported by Parker and Hodge are, therefore, a group that may well have been receiving digitalis and it is natural to wonder if any of the delirious patients were suffering from overlooked intoxication. They make no

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