The Withdrawal of Benztropine Mesylate in Chronic Schizophrenic Patients
The British Journal of PsychiatryPublished 1 December 1983
Linda A. Baker, L. Y. Cheng, I. Ben Amara
Citations67
SJR quartileQ1
SJR score2.47
SNIP2.17
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Sub-test scores suggest that deficits in attention and concentration were induced by treatment with benztropine, and it is suggested that antiparkinsonian agents should be prescribed only if and when EPS occur.
Abstract
In this double-blind, four-week study, 28 chronic schizophrenic patients receiving neuroleptic medication plus the antiparkinsonian drug, benztropine mesylate, were either switched to placebo or maintained on benztropine. Patients withdrawn from benztropine reliably increased their overall scores on the Wechsler Memory Scale in comparison with the drug group. Sub-test scores suggest that deficits in attention and concentration were induced by treatment with benztropine. Psychotic decompensation appeared to develop simultaneously with extrapyramidal symptoms (EPS) in some patients, but only 14.2 per cent of the placebo group experienced extrapyramidal symptoms severe enough to require resumption of benztropine therapy. It is suggested that antiparkinsonian agents should be prescribed only if and when EPS occur.
Keywords
Medicine
Archives of General PsychiatryAn Inventory for Measuring Depression
38,163 Citations1961Aaron T. Beck
The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out and a wide variety of psychiatric rating scales have been developed.
Manual for the State-Trait Anxiety Inventory
25,350 Citations1970Charles D. Spielberger, Richard L. Gorsuch +1 more
Acta Psychiatrica ScandinavicaA RATING SCALE FOR EXTRAPYRAMIDAL SIDE EFFECTS
3,263 Citations1970G. M. Simpson, M. B. +4 more
A modification of an earlier rating scale for extrapyramidal system disturbance is described, and evidence for the validity and reliability of the scale is presented.
Archives of NeurologyHuman Memory and the Cholinergic System
1,392 Citations1974David A. Drachman
Comparisons of the memory and cognitive deficits induced by scopolamine with the performance of aged subjects revealed a marked similarity of pattern, and the possible theoretical explanations for the behavioral similarity seen with central cholinergic blockade and normal aging are discussed.
NeurologyMemory and cognitive function in man
619 Citations1977David A. Drachman
Physostigmine, a pharmacologic antagonist of scopolamine, markedly improved M/C functions; amphetamine failed to produce M/ cognitive improvement, although alertness was improved, and activity in catecholaminergic neurons presumably increased, which supports a specific role for cholinergic neurons in M-C processes.
Archives of General PsychiatryAntischizophrenic Drugs and Brain Cholinergic Receptors
475 Citations1974Solomon H. Snyder
The influence of a variety of antisch schizophrenic drugs on the brain's receptor for the muscarinic action of acetylcholine is reported to provide a means to predict extrapyramidal actions of new potential antischizophrenic drugs.
ScienceFlexible System for the Diagnosis of Schizophrenia: Report from the WHO International Pilot Study of Schizophrenia
448 Citations1973William T. Carpenter, John S. Strauss +1 more
Behavioral data on a large patient group collected by investigators from nine countries in the International Pilot Study of Schizophrenia resulted in an operational method for identifying patients who would be commonly considered schizophrenic in many centers.
Psychological ReportsNOSIE-30: A Treatment-Sensitive Ward Behavior Scale
355 Citations1966Gilbert Honigfeld, Roderic D. Gillis +1 more
The NOSIE-30, especially designed for use by subprofessional personnel, provides an economical and accurate means of systematically assessing patient status and change and cross-validation of these six factor scores and a composite score, Total Patient Assets, were obtained.
Archives of General PsychiatryPhysostigmine
192 Citations1975Robert P. Granacher
Physostigmine, uniquely among the available reversible anticholinesterase agents, can pass the blood-brain barrier to exert central as well as peripheral cholinomimetic actions to reverse this syndrome of agitation and toxic confusional psychosis.
JAMAReversal of Central Anticholinergic Syndrome in Man by Physostigmine
147 Citations1968Roger C. Duvoisin
Physostigmine salicylate in doses of 1 to 2 mg administered parenterally was found to be an effective antidote to intoxication with centrally active anticholinergic agents.
Archives of General PsychiatryEvaluating the Long-Term Need for Antiparkinson Drugs by Chronic Schizophrenics
112 Citations1972C. James Klett
From these and other data, it is recommended that clinicians reconsider their prescribing habits, particularly prophylactic and long-term use of antiparkinson drugs.
American Journal of PsychiatryConfusional Episodes and Antidepressant Medication
97 Citations1971Robert K. Davies, G Tucker +2 more
The clinical picture was that of a toxic psychosis, and the reactions responded favorably to a decrease in dosage of the antidepressant and/or the addition of a phenothiazine, along with increased attention to environmental factors.
Journal of Pharmacology and Experimental TherapeuticsCENTRAL NERVOUS SYSTEM EFFECTS OF HYOSCINE IN MAN
79 Citations1962Adrian M. Ostfeld, Alayne Aruguete
It is suggested that the depression of the EEG "arousal" response may be attributed to an action of hyoscine on the ascending reticular activating system, which occurs independently of the action on the spontaneous EEG rhythm.
The British Journal of PsychiatryAnti-Cholinergic Drugs and Memory: the Effects of Benzhexol on Memory in a Group of Geriatric Patients
71 Citations1982G. Potamianos, J. M. Kellett
All tests were significantly impaired by the benzhexol except for digit span, which suggests that muscarinic blocking drugs should be avoided in the elderly, as they mimic the memory deficits found in senile dementia of Alzheimer type.
The Journal of Nervous and Mental DiseaseTHERAPEUTIC REVERSAL WITH BENZTROPINE IN SCHIZOPHRENICS
69 Citations1975Man Mohan Singh, Stanley R. Kay
The benztropine reversal of therapeutic changes provided a valuable pharmacological model for understanding the neurobiological basis of schizophrenic decompensation and its restitution with neuroleptics, and was considered as indirect evidence suggesting that cholinergic neuronal mechanisms are involved in both of these processes.
Psychological MedicineComparison of amantadine, orphenadrine, and placebo in the control of phenothiazine-induced Parkinsonism
68 Citations1972R. H. S. Mindham, Raghunandan Gaind +2 more
The findings of the present study are not conclusive but show a clear need for further research in this field, and the paucity of evidence for the effectiveness of anti-cholinergic drugs in both Parkinson's disease and in drug-induced Parkinsonism.
PsychosomaticsAntiparkinson Drug Overuse
66 Citations1970Alberto DiMascio, Edward Demirgian
The use of psychotropic drugs such as the phenothiazines, thioxanthenes, and butyrophenones as effective means of treating schizophrenic patients is a common practice in psychiatry today.
The Journal of Nervous and Mental DiseaseREVERSAL OF SOME THERAPEUTIC EFFECTS OF AN ANTIPSYCHOTIC AGENT BY AN ANTIPARKINSONISM DRUG
61 Citations1973Man Mohan Singh, James M. Smith
Data are presented from a multidimensional, longitudinal study in 10 acute schizophrenics which indicate that the addition of benztropine to haloperidol reversed the course of some of the therapeutic changes.
British Journal of Social and Clinical PsychologyThe Structure of the Wechsler Memory Scale and its Relationship to ‘Brain Damage’
58 Citations1973J. J. Kear‐Colwell
The general conclusion was that the more diffuse the involvement of brain tissue the greater the memory disturbance, as measured by the Wechsler Memory Scale, which does not support a unitary view of brain damage and its cognitive effects.
American Journal of PsychiatryReversal of Antiparkinsonian Drug Toxicity by Physostigmine: A Controlled Study
57 Citations1973M. Khaled El‐Yousef, David S. Janowsky +2 more
Three female schizophrenic patients receiving a combination of psychotropic agents, including the antiparkinsonian agent benztropine mesylate, developed the central anticholinergic syndrome, consisting of hallucinations, anxiety, short-term memory loss, disorientation, and agitation, which responded dramatically to physostigmine salicylate administered intramuscularly.
American Journal of PsychiatryAntiparkinsonian Agents and Depot Phenothiazine
57 Citations1974Ching‐Piao Chien, Alberto DiMascio +1 more
It is concluded that the routine prophylactic use of AP drugs is questionable but that further research is necessary.
American Journal of PsychiatryATROPINE COMA: A SOMATIC THERAPY IN PSYCHIATRY
55 Citations1958Gordon R. Forrer, Jacob J. Miller
Increased accessibility, better contact with reality, and more appropriate affective responses are found immediately after termination of coma, persisting several hours, providing the opportunity for more effective psychotherapeutic assistance.
American Journal of PsychiatryThe need for continuous use of antiparkinsonian medication with chronic schizophrenic patients receiving long-term neuroleptic therapy
46 Citations1981N. Manos, John Gkiouzepas +1 more
The authors conclude that these data support the need for continuous use of antiparkinsonian medication in the long-term neuroleptic therapy of chronic schizophrenic patients.
The British Journal of PsychiatryCognitive Functions in Manic-Depressives: Effects of Lithium and Physostigmine
35 Citations1978Rosemary Telford, E. P. Worrall
Cognitive functions were investigated in seven manic-depressive patients while on lithium, after two weeks off lithium, and after a subcutaneous injection of physostigmine while on Lithium, where test performance was unaffected by lithium, but after physostIGmine the I.Q. scores were significantly increased.
Archives of General PsychiatryExtrapyramidal Side Effects in Chlorpromazine Recipients
19 Citations1977Chester Swett
The data in this small sample indicated that the prophylactic use of benztropine had no effect in reducing the rate of EPS.
Canadian Psychiatric Association JournalBenztropine Psychosis
15 Citations1973J. Ananth, R.C. Jain
Benztropine mesylate is a synthetic com pound obtained by combining the tropine portion of the atropine molecule with the benzohydryl portion of diphenhydramine that possesses both anticholinergic and antihistaminic properties.
Advances in behavioral biologyPhysostigmine in the Treatment of Drug Overdose
11 Citations1978S.‐M. Aquilonius
The capability of an extract of the Calabar bean to antagonize the mydriatic effect of atropine was known to Kleinwachter who introduced antidote treatment of overdosage with anticholinergic drugs in 1864 and a pure alkaloid was isolated from the West African bean and named physostigmine.
Canadian Psychiatric Association JournalProtracted Vomiting following Abrupt Cessation of Psychotropics: A Case Report
9 Citations1978Thomas P. Kalman, Gloria Marmar Warner
The case of a 23–year-old patient treated with haloperidol, imipramine, and benztropine mesylate is presented to illustrate an unusually severe reaction to the abrupt cessation of neuroleptic medication.
Schizophrenia BulletinDo Anticholinergics Antagonize Antipsychotic Drug Action?
5 Citations1978Theresa Ziemba, Herbert Y. Meltzer +1 more