Case Report
Year: 2021 | Month: June | Volume: 11 | Issue: 6 | Pages: 231-233
DOI: https://doi.org/10.52403/ijhsr.20210636
A Case Report of Delirium Induced by Herbal Laxative Senna
Nimitha K J1, Porimita Chutia2, Pooja Misal3, Bhupendra Singh4
1,2,3 Senior Resident, 4Additional Professor,
Department of Geriatric Mental Health, King George’s Medical University, Lucknow, India
Corresponding Author: Nimitha K J
ABSTRACT
Constipation is one major complaint in elderly population. It may be due to physiological and anatomical reasons of aging, but it can be also due chronic medical and mental illnesses and due to use of multiple medications. Constipation itself is a precipitating factor for delirium. Drugs used for constipation can also be the culprit. A 64-year-old female who had a history of hypertension and chronic constipation presented with symptoms of confused and altered behavior, decreased oral intake, decreased sleep. On history taking it was known that she was using Herbal medication containing senna glycoside and other compounds since 8-9months. On examination she had signs of dehydration, disoriented and attention was impaired. On investigation her serum sodium was 122.6 mmol/ and other investigations were within normal limits. She was diagnosed as a case of Delirium according to ICD-10 criteria. Her dehydration was corrected by giving intravenous fluids and serum sodium level was corrected using salt capsules 2 tablets thrice daily. For disturbed sleep she was prescribed Tab Melatonin 10mg at bedtime and constipation was treated with per rectal enema and syrup lactulose 30ml at bedtime. Patient improved in 1 week time. Senna a herbal laxative used to treat constipation. It can alter intestinal electrolyte transportation and irritates intestinal mucosa. It is due to increased peristalsis and increased defecation and even diarrhea Prolonged use can cause dehydration, electrolyte imbalance and delirium. Senna, an over-the-counter laxative with FDA approval is a matter of concern in the current scenario. This case report warns into the judicious use of laxatives containing senna in elderly population.
Key words: Delirium, Herbal Laxative, Senna, Constipation.