Atropine is the most commonlyused drug for the treatment of organophosphorus poisoning which may occasionally lead to central nervous system side effects like psychosis and delirium. Discontinuation of atropine, modification of the dosage or replacement with other medications may be required alongwith antipsychotics and sedatives in such cases. We report herein a case of suicidal ingestion of organophosphorus insecticide (ANACONDA) who received atropine infusion for the management of muscarinic symptomsbut developed psychotic features during treatment. Atropine was discontinued and replacement done with glycopyrrolate infusionwhich could successfully counteract the muscarinic features. The use of glycopyrrolate as replacement in atropine psychosis and the recommended dosage regimen has been sparsely described in literature.

Keywords: Organophosphorus poisoning; Atropine psychosis; Glycopyrrolate; Bronchorrhoea.