Magera et al1 reported successful seizure control with physostigmine after acute ingestion of hydroxyzine. We concur with the authors' recommendation for cautious use of physostigmine. The authors point out that physostigmine-induced seizures have been reported following rapid intravenous administration and recommended that it be "administered slowly." We would like to clarify further the rate of administration. It has been recommended that the dose of physostigmine be administered intravenously over a two- to five-minute period to minimize the possibility of seizures.2,3

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