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Discussion

Cogentin buzz?

Has anyone ever heard of pts getting a buzz from IM Cogentin? I have a pt who insists that PO cogentin doesn't work, only IM. Her only complaint is eye rolling, and that seems to come and go, depending on whether or not she knows I'm looking at her. :bugeyes: I'm just trying to figure out why anyone would fake EPS to get a shot?

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  • Experts

I have pts that without any really obvious agitation, yes I know I'm not to be the ultimate judge of this lol, insist on IMs and personally I think for some its about the quicker response and for most its about the rush of getting the needle.

  • Author

I didn't think about someone getting off on the needle stick! The other possibility that I thought of is that this patient is very borderline, so maybe this fits in with her "identity" as a mental patient. She has been in the hospital quite a while. She says things like, "I have institutionalized behaviors." She also seems to pick up anybody else's symptoms that are worse than hers or more interesting than hers. I guess she thinks it's catching! We did have someone on the unit who had EPS for real. I can't remember if he got IM Cogentin or just PO. I could have sworn she was on a different unit during that time. Maybe she heard about it?

I think it's possible to get a "buzz" from IM Cogentin. A side effect of cogentin is "false sense of well-being". Since IM Cogentin would be effective quicker than PO, it could give a "zing." Cogentin increases dopamine--dopamine can be "zingy."

That being said, getting a buzz from a med isn't a reason to be given the med!

Yeah I have heard that also regarding people who have been drug abusers in the past a "needle buzz" works as a mini fix for them. I also have another patient who insists on IM Prolixin because he is certain the POs are poison. Sounds like your right-on regarding the borderline part as well, borderlines will do about anything for a bit more attention.

could you get "atropine psychosis" from a big enough dose? people can get a buzz from benadryl, too, yes?

  • Experts

I've had many clients over the years attempt to fake EPS because they wanted Cogentin (felt they got a "buzz" from it), but the people I've encountered didn't have a preference for IM -- plain ol' po Cogentin would do just fine.

On the other hand, I have encountered people who tried to come up with all sorts of reasons why they needed Ativan IM instead of po.

Interesting regarding the IM's.

I have seen in the past, research material regarding PET scans...that just the witnessing/handling of the syringe and needle initiates a "mini high" all its own in addicts. Sort of like the mini high before the big high.

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