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ARTICLE |

Cimetidine Toxic Reactions Masquerading as Delirium Tremens

William W. Weddington Jr, MD; Anna E. Muelling, MD; Hans H. Moosa; Chase P. Kimball, MD; Randall R. Rowlett, MD
JAMA. 1981;245(10):1058-1059. doi:10.1001/jama.1981.03310350046023.
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CIMETIDINE, an inhibitor of gastric acid secretion, is widely used for the treatment of peptic ulcer and to prevent gastrointestinal (GI) bleeding in high-risk patients. Infrequent side effects of cimetidine include headache, dizziness, fatigue, rash, diarrhea, constipation, muscle pain, gynecomastia, and granulocytopenia.1,2

Grimson3 reported two cases of mental confusion after patients received double dosages. Subsequently, other case reports4-6 described cimetidine-associated confusion, delirium, depression, and coma. We describe a patient in whom a cimetidine-associated delirium developed that initially was thought to be alcohol withdrawal. Subsequent treatment of presumed delirium tremens led to a worsened clinical state.

Report of a Case  A 64-year-old woman was admitted to a hospital for upper abdominal pain. She had a history of drinking several beers each day, but her blood alcohol level was 0 mg/dL at admission. A nasogastric aspirate was guiac positive, and a spot urine amylase was positive. Her BUN and

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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