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Bromism
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Bromism
Bromism is the syndrome which results from the long-term consumption of bromine, usually through bromine-based sedatives such as potassium bromide and lithium bromide. Bromide was used in medicinal drugs for indications as broad as insomnia, hysteria, anxiety, and even excessive libido, making it one of the most frequently used class of medicinal drugs prior to its reduction in the early 20th century.
Bromism was once a very common disorder, being responsible for 5 to 10% of psychiatric hospital admissions, but is now uncommon since bromide was withdrawn from clinical use in many countries and was severely restricted in others. However, a man was poisoned in 2025, after a suggestion of ChatGPT to replace sodium chloride in his diet with sodium bromide; sodium bromide is a safe replacement only for non-nutritional purposes, i.e., cleaning.
Neurological and psychiatric symptoms are widely variable. Common symptoms may include restlessness, irritability, ataxia, paranoia, confusion, both auditory and visual hallucinations, psychosis, weakness, stupor, and, in severe cases, coma.
Gastrointestinal effects include nausea and vomiting as acute adverse effects. Chronic exposure may lead to anorexia or constipation.
Dermatological effects include cherry angiomas, acneiform, and pustular and erythematous rashes.
High levels of bromide chronically impair the membrane of neurons, which progressively impairs neuronal transmission, leading to toxicity, known as bromism. Bromide has an elimination half-life of 9 to 12 days, which can lead to excessive accumulation. Doses of 0.5 to 1 gram per day of bromide can lead to bromism. Historically, the therapeutic dose of bromide is about 3 to 5 grams of bromide, thus explaining why chronic toxicity (bromism) was once so common. While significant and sometimes serious disturbances occur to neurologic, psychiatric, dermatological, and gastrointestinal functions, death is rare from bromism.
Bromism is caused by a neurotoxic effect on the brain which results in somnolence, psychosis, seizures, and delirium. Bromism has also been caused by excessive consumption of soft drinks that contains brominated vegetable oil, leading to headache, fatigue, ataxia, memory loss, and potentially inability to walk was observed in one case.
Bromism is diagnosed by checking the serum chloride level, electrolytes, glucose, blood urea nitrogen and creatinine, as well as symptoms such as psychosis. Bromine is also radiopaque, so an abdominal X-ray may also help in the diagnosis.
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Bromism
Bromism is the syndrome which results from the long-term consumption of bromine, usually through bromine-based sedatives such as potassium bromide and lithium bromide. Bromide was used in medicinal drugs for indications as broad as insomnia, hysteria, anxiety, and even excessive libido, making it one of the most frequently used class of medicinal drugs prior to its reduction in the early 20th century.
Bromism was once a very common disorder, being responsible for 5 to 10% of psychiatric hospital admissions, but is now uncommon since bromide was withdrawn from clinical use in many countries and was severely restricted in others. However, a man was poisoned in 2025, after a suggestion of ChatGPT to replace sodium chloride in his diet with sodium bromide; sodium bromide is a safe replacement only for non-nutritional purposes, i.e., cleaning.
Neurological and psychiatric symptoms are widely variable. Common symptoms may include restlessness, irritability, ataxia, paranoia, confusion, both auditory and visual hallucinations, psychosis, weakness, stupor, and, in severe cases, coma.
Gastrointestinal effects include nausea and vomiting as acute adverse effects. Chronic exposure may lead to anorexia or constipation.
Dermatological effects include cherry angiomas, acneiform, and pustular and erythematous rashes.
High levels of bromide chronically impair the membrane of neurons, which progressively impairs neuronal transmission, leading to toxicity, known as bromism. Bromide has an elimination half-life of 9 to 12 days, which can lead to excessive accumulation. Doses of 0.5 to 1 gram per day of bromide can lead to bromism. Historically, the therapeutic dose of bromide is about 3 to 5 grams of bromide, thus explaining why chronic toxicity (bromism) was once so common. While significant and sometimes serious disturbances occur to neurologic, psychiatric, dermatological, and gastrointestinal functions, death is rare from bromism.
Bromism is caused by a neurotoxic effect on the brain which results in somnolence, psychosis, seizures, and delirium. Bromism has also been caused by excessive consumption of soft drinks that contains brominated vegetable oil, leading to headache, fatigue, ataxia, memory loss, and potentially inability to walk was observed in one case.
Bromism is diagnosed by checking the serum chloride level, electrolytes, glucose, blood urea nitrogen and creatinine, as well as symptoms such as psychosis. Bromine is also radiopaque, so an abdominal X-ray may also help in the diagnosis.