eMedicine Specialties > Neurology > Neurotoxicology

Organic Solvents: Treatment & Medication

Author: Jonathan S Rutchik, MD, MPH, Assistant Professor, Department of Occupational and Environmental Medicine, University of California at San Francisco
Contributor Information and Disclosures

Updated: Nov 9, 2009

Treatment

Medical Care

For acute or emergency scenarios, symptomatic treatment is usually the mainstay of medical care. After emergency issues are addressed, reducing the intensity or eliminating exposure is the appropriate goal.

  • Reducing inhalation, ingestion, or dermatologic exposures may be accomplished by not eating or smoking in the workplace and by improving use of PPE, including masks and breathing apparatuses. Other protective measures are wearing gloves made of latex, Vicryl, or other impermeable material to limit skin absorption and by showering and changing clothes on completion of job tasks.
  • Changing the duration of exposure is also important. This may be accomplished by changing shifts and rotating jobs in a department.
  • Engineering controls, such as improving ventilation or shifting chemical processes to less-toxic substitutes, are other actions that the clinician might suggest.
  • Removal from exposure may follow a reduction of exposure if symptoms are severe, life threatening, or persistent. Reduction and/or removal are important diagnostic and treatment options. If symptoms abate after these steps, they better support the diagnosis of sequelae secondary to exposure than if they persist.
  • Clinicians should be willing to follow up their patients and to determine if their symptoms are improving compared with their relative exposure. A clinician must be willing to consider recommending a job change (eg, modified or restricted duty) to the employer. At that point, referral to appropriate specialists may be indicated.
  • Antidepressant medication, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, have been helpful for managing the alterations of mood that may be part of the syndrome, as well as for reducing pain in patients with symptoms of peripheral neuropathy.
  • Psychological counseling, brain rehabilitation, and physical and occupational therapy may be appropriate.

Consultations

The patient may be referred to an internist, occupational medicine specialist, ophthalmologist, neuropsychologist, neuromuscular or behavioral neurologist, or other specialists depending on the specifics of the case.

Medication

Many classes of medications may be appropriate for patients exposed to organic solvents. The selection is case specific. Antianxiety medication in the form of benzodiazepines, tricyclic antidepressants, and SSRIs, as well as other categories of pharmaceuticals, may be appropriate.

More on Organic Solvents

Overview: Organic Solvents
Differential Diagnoses & Workup: Organic Solvents
Treatment & Medication: Organic Solvents
Follow-up: Organic Solvents
References
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References

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Further Reading

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Keywords

chemical solvents, chemical toxicity, industrial chemicals, industrial exposures, industrial solvents, toxic exposures

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Contributor Information and Disclosures

Author

Jonathan S Rutchik, MD, MPH, Assistant Professor, Department of Occupational and Environmental Medicine, University of California at San Francisco
Jonathan S Rutchik, MD, MPH is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Occupational and Environmental Medicine, and Society of Toxicology
Disclosure: Nothing to disclose.

Medical Editor

Roberta J Seidman, MD, Associate Professor of Clinical Pathology, Stony Brook University; Director of Neuropathology, Department of Pathology, Stony Brook University Medical Center
Roberta J Seidman, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuropathologists, New York Association of Neuropathologists (The Neuroplex), and Suffolk County Society of Pathologists
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Glenn Lopate, MD, Associate Professor, Department of Neurology, Division of Neuromuscular Diseases, Washington University School of Medicine; Chief of Neurology, St Louis ConnectCare, Consulting Staff, Barnes Jewish Hospital
Glenn Lopate, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Tarakad S Ramachandran, MBBS, FRCP(C), FACP is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners, American College of International Physicians, American College of Managed Care Medicine, American College of Physicians, American Heart Association, American Stroke Association, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, and Royal Society of Medicine
Disclosure: Abbott Labs  Honoraria Consulting; Teva Marion Honoraria Consulting; Boeringer-Ingelheim Honoraria Speaking and teaching

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