Acute Manic Psychosis Following the Dermal Application of N,N-Diethyl-M-Toluamide (deet) in an Adult

Summary: Clinical Toxicology
1986, Vol. 24, No. 5, Pages 429-439 , DOI 10.3109/15563658608992605

Acute Manic Psychosis Following the Dermal Application of N,N-Diethyl-M-Toluamide (deet) in an Adult

J. W. Snyder‌, R. O. Poe‌, J. F. Stubbins‌ and L. K. Garrettson‌
Departments of Pharmacology and Toxicology, Eastern Virginia Medical School, Norfolk, Virginia, 23501
Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia, 23501
Medicinal Chemistry Medical College of Virginia Virginia Commonwealth University, Richmond, Virginia, 23298
Pediatrics and Pharmaceutics Medical College of Virginia Virginia Commonwealth University, Richmond, Virginia, 23298

Abstract
Extensive animal testing and 30 years of human experience have established the general safety of DEET when applied episodically to skin or bedclothes. Local and systemic toxic and allergic reactions to DEET have been observed in man. Three weeks prior to admission, for the purpose of self-medication, a 30 year old man began daily applications of the insect repellant, DEET followed by a 1-2 hour period in a light-bulb heated box. Sedation and incoherence were noted for short periods following each application session. Aggressiveness and psychotic ideation led to hospital admission where he displayed psychomotor hyperactivity, rapid and pressured speech, tangentiality, flight of ideas, and grandiose delusions. Treatment was begun with haloperidol. Clinical improvement was complete within 6 days, atypical for classic endogenous mania. Drug and metabolites were identified in the urine more than 2 weeks after the last drug application.
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