Dr. Kimmyben Patel (M.B.B.S), Dr. Ankitkumar B. Patel (M.B.B.S),
*Dr.Pokhraj Suthar (M.B.B.S, M.D.), Dr. Tarangkumar R. Bhavsar (M.B.B.S)


Pyrethroid, an insecticide is an uncommon substance of abuse in Asian countries. Cholinergic and symphathetic symptoms along with psychiatric symptoms in such rare substance of abuse have not yet been described. A 39-year-old Asian male with past psychiatric history of methamphetamine dependence and bipolar disorder type 1, came to the emergency department because of suicidal ideation with a plan to slash his throat. The patient was very agitated during initial assessment. In the emergency room (ER), the patient reported that he had been using methamphetamine for the last four years. His last use was six hours before coming to the ER and that was his only use during the past six to eight weeks. His affect was flat and irritable. His urinary drug screen was positive for amphetamines, methamphetamines, and cannabinoids. The patient reported that it would give him the same high as methamphetamine and he would occasionally have feelings of déjà vu. The patient also reported having olfactory hallucinations while using it. The patient had been using the insecticide for six to eight weeks and only used methamphetamine one (1) day before coming to the ER. The patient had suicidal ideations apparently precipitated by his use of pyrethroid. His statements about friends using it intravenously highlight the phenomenon of an under reported substance being abused with little or no telltale signs by people with high risk for self-harm.

Keywords: Psychiatrics, Substance of abuse, Pyrethroid.

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