The newly described quaternary ammonium compound, Banthinet (B-diethylaminoethyl xanthene-9-carboxylate methobromide) has been found to be a useful drug in the therapy of peptic ulcer, spastic colon and certain other disturbances in which over-activity of the parasympathetic innervation exists due to its atropine like action1 • 2 • 3 • 4• Like atropine, it reduces gastric and bowel motility, although in therapeutic doses this reduction of motility is relatively greater than can be obtained with therapeutic doses of atropine5• The drug also reduces the volume of gastric secretion and to some extent the degree of gastric acidity5• It resembles atropine also in that it produces side reactions similar to those caused by intensive atropine medication. These consist of dry mouth, blurred vision and occasionally urinary retention. These symptoms in most cases seem to subside after 48 to 72 hours of treatment with the drug even though treatment is continued at the same dosage level. It does not seem to have the cardiovascular effects of atropine. Banthine is said to exert a blocking effect on both sympathetic and parasympathetic ganglia, although in the usual therapeutic dosages the blocking effect is more marked on the parasympathetic ganglia. It is thought that the drug also has an atropine effect on post-ganglionic cholinergic nerve endings. In the course of evaluating the effect of this drug on a group of 50 patients with peptic ulcer or spastic colon, six of the patients complained of symptoms or manifested behavior suggesting a central nervous system stimulating effect from Banthine. These symptoms consisted of mild elation which in one case seemed almost hypomanic, sensations of floating or unreality, and in one case, a patient (G. M.) on Banthine therapy developed a full blown psychotic reaction which subsided when the drug was withheld for 24 hours (Table I). In general, these subjective symptoms suggesting a central stimulating effect by the drug commence soon after therapy is begun and subside spontaneously as do the other side reactions after about the second or third day of treatment. However, two patients, (G. R. and S. S.) continued to manifest a moderate degree of elation or hyperactivity after the third day. In both these cases this