Side Effects of benztropine: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Benztropine is an anticholinergic medication used to reduce extrapyramidal symptoms (EPS) caused by antipsychotic drugs. EPS caused by antipsychotic drugs include muscle stiffness, tremors, slow movements, and involuntary movements. Benztropine works by adjusting the balance of dopamine neurotransmitters to reduce these symptoms.

Studies have shown that benztropine is effective in reducing EPS caused by antipsychotic drugs. For example, 6 suggested that patients tend to relapse EPS after discontinuation of benztropine, and that the risk of EPS relapse is higher when the dose of benztropine is lower than the dose of antipsychotic drugs.

On the other hand, benztropine is also known to have some side effects. The main side effects include dry mouth, constipation, blurred vision, urinary retention, and sexual dysfunction. Benztropine has anticholinergic effects, so these side effects are thought to be caused by suppressing the activity of the parasympathetic nervous system. Benztropine can also have negative effects on memory and cognitive function. 14 showed that benztropine impaired free recall and perception of time compared to amantadine.

Benztropine is effective in treating EPS, but it also has side effects. Therefore, benztropine should be used carefully under the guidance of a physician.

Reasons for side effects

Benztropine is an anticholinergic drug that inhibits the parasympathetic nervous system. The parasympathetic nervous system controls the activity of organs such as digestion, excretion, respiration, and the heart. When benztropine inhibits the parasympathetic nervous system, these organs are suppressed, leading to side effects such as dry mouth, constipation, blurred vision, urinary retention, and sexual dysfunction.

Common side effects

Dry mouth

Benztropine inhibits the parasympathetic nervous system, reducing saliva secretion. This causes dry mouth. 14

Constipation

Benztropine inhibits the parasympathetic nervous system, suppressing intestinal peristalsis. This can lead to constipation. 14

Blurred vision

Benztropine inhibits the parasympathetic nervous system, suppressing pupillary constriction. This can cause blurred vision. 14

Urinary retention

Benztropine inhibits the parasympathetic nervous system, suppressing bladder contraction. This can cause urinary retention. 14

Sexual dysfunction

Benztropine inhibits the parasympathetic nervous system, suppressing penile erection and ejaculation. This can cause sexual dysfunction.

Impaired memory and cognitive function

Benztropine may have negative effects on memory and cognitive function. 14

Side effect countermeasures

Dry mouth

To counter dry mouth, it is important to drink plenty of fluids. Sucking on sugar-free gum or candy can also be effective.

Constipation

To counter constipation, it is important to eat foods high in fiber and exercise. Laxatives can also be used as needed.

Blurred vision

Blurred vision can sometimes be improved by reducing the dose of benztropine. Adjusting the prescription for eyeglasses can also be effective.

Urinary retention

To counter urinary retention, medications that promote urination can be used, and bladder training can be done.

Sexual dysfunction

Sexual dysfunction can sometimes be improved by reducing the dose of benztropine. If necessary, sex-enhancing drugs can be used.

Impaired memory and cognitive function

Impaired memory and cognitive function can sometimes be improved by reducing the dose of benztropine. If necessary, cognitive-enhancing drugs can be used.

Comparison between studies

Commonalities between studies

Many studies have shown that benztropine is effective in reducing EPS caused by antipsychotic drugs. It is also common to observe side effects such as dry mouth, constipation, blurred vision, urinary retention, and sexual dysfunction with benztropine.

Differences between studies

The incidence and severity of benztropine side effects vary from study to study. For example, 14 showed that benztropine impaired free recall and perception of time compared to amantadine, but other studies have not reported such side effects. Therefore, the side effects of benztropine may vary depending on the patient and the research method.

Precautions for real-life application

Benztropine is effective in treating EPS, but it also has side effects. Therefore, benztropine should be used carefully under the guidance of a physician. In particular, elderly patients and patients with impaired liver or kidney function should be cautious when taking benztropine. Benztropine should also not be taken by pregnant or breastfeeding women. Consult your doctor before taking benztropine.

Limitations of current research

Research on benztropine is not yet complete. In particular, there are many unknowns about the long-term effects of benztropine. Also, the mechanism of how benztropine works is not yet fully understood.

Future research directions

Further research is needed to elucidate the long-term effects and mechanism of action of benztropine. It is also important to develop methods to reduce the side effects of benztropine.

Conclusion

Benztropine is effective in reducing EPS caused by antipsychotic drugs, but side effects such as dry mouth, constipation, blurred vision, urinary retention, and sexual dysfunction can occur. Benztropine should be used carefully under the guidance of a physician.

Benztropine was developed to reduce EPS caused by antipsychotic drugs. EPS is a common symptom of antipsychotic drug side effects. Benztropine is effective in treating EPS, but it also has side effects. Be sure to take benztropine carefully under the guidance of your doctor.

Literature analysis of 26 papers
Positive Content
22
Neutral Content
0
Negative Content
4
Article Type
8
1
1
3
26
1.

Parkinson's disease: Cogentin with Sinemet, a better response.

Author: TourtellotteW W, PotvinA R, SyndulkoK, HirschS B, GildenE R, PotvinJ H, HanschE C

Improves Parkinson's symptoms
No important adverse side effects

Benztropine mesylate (Cogentin) was evaluated as an adjuvant to levadopa-carbidopa (Sinemet) in 29 patients with Parkinson's disease. The combination of Sinemet and benztropine resulted in significantly greater improvement than Sinemet alone, as indicated by both clinician and patient assessments. Benztropine improved rigidity, finger tapping speed, and activities of daily living. No significant side effects were observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Potential use of ipatropium bromide for the treatment of clozapine-induced hypersalivation: a preliminary report.

Author: CalderonJ, RubinE, SobotaW L

Reduced sialorrhea
Minor side effects

Intranasal ipatropium bromide (IPB) may be useful for clozapine-induced sialorrhea in patients who failed to respond to anticholinergic or adrenergic agents. Intranasal IPB lacks significant systemic anticholinergic effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Pharmacologic treatment of priapism in two horses.

Author: WilsonD V, NickelsF A, WilliamsM A

Effective for priapism
None observed

Benztropine mesylate was successfully used to treat priapism in two horses. Following intravenous injection, both horses exhibited a rapid resolution of signs with no reported side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

The initiation of long-term pharmacotherapy in schizophrenia: dosage and side effect comparisons between oral and depot fluphenazine.

Author: SchoolerN R, LevineJ

Dosage equivalence
Extrapyramidal symptoms
Sleep disturbance

Oral and depot fluphenazine had comparable efficacy in treating acutely psychotic patients with no significant difference in side effects observed during the early weeks of administration.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

5.

Formulation and biopharmaceutical evaluation of transdermal patch containing benztropine.

Author: HaiNguyen Thien, KimJuyoung, ParkEun-Seok, ChiSang-Cheol

Parkinson's treatment
Reduced side effects

A drug-in adhesive (DIA) patch containing benztropine (BZ) provides a potential transdermal treatment for Parkinson's disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Anticholinergic equivalents and parkinsonism: a model for predicting side-effects of antipsychotic drugs.

Author: MenkesD B, ClarksonH O, Caradoc-DaviesG, MullenP E

Reduced EPS
EPS relapse

The balance between antipsychotic and antimuscarinic activity was found to be crucial for managing extrapyramidal side effects, suggesting a potential for optimizing antiparkinson drug requirements.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Gingival pain: an unusual side effect of ziprasidone.

Author: RaghunathAshwati

Gingival pain

This case report describes a patient with schizophrenia who developed severe gingival pain after his ziprasidone dosage was increased. The pain subsided after taking benztropine and the patient's ziprasidone dosage was decreased.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Extrapyramidal side effects in chlorpromazine recipients: emergence according to benztropine prophylaxis.

Author: SwettC, ColeJ O, ShapiroS, SloneD

Extrapyramidal symptoms

The frequency of extrapyramidal symptoms (EPS) attributed to chlorpromazine was compared in 86 patients receiving benztropine for EPS prevention and 568 patients receiving chlorpromazine alone. The study found no significant difference in the rate of EPS between the two groups, suggesting that prophylactic use of benztropine does not reduce the rate of EPS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

11.

Meige syndrome: relief on high-dose anticholinergic therapy.

Author: DuvoisinR C

Improved Meige syndrome
Improved torticollis
Memory impairment

Benztropine mesylate was effective in treating a patient with Meige syndrome and spasmodic torticollis. The major side effect was mild memory impairment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Overeating after midbrain 6-hydroxydopamine: prevention by central injection of selective catecholamine reuptake blockers.

Author: HernandezL, HoebelB G

Controls body weight
Inhibits food intake
Delayed overeating
Gastric distress

This study investigated the role of norepinephrine depletion in hyperphagia and obesity induced by 6-hydroxydopamine (6-OHDA) in rats. Local injection of amphetamine or desmethylimipramine before 6-OHDA prevented hyperphagia and obesity by partially preventing catecholamine depletion in the forebrain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Anticholinergic effects on memory: benztropine versus amantadine.

Author: GelenbergA J, Van PuttenT, LavoriP W, WojcikJ D, FalkW E, MarderS, Galvin-NadeauM, SpringB, MohsR C, BrotmanA W

Blurred vision
Dry mouth
Memory impairment
Time perception impairment

Benztropine, an anticholinergic agent, can impair cognition and other functions. In a double-blind crossover trial of 60 healthy volunteers, benztropine, but not amantadine, impaired free recall and perception of time. Subjects' perception of their own memory impairment was also significantly greater with benztropine. Benztropine decreased salivary flow to a greater degree than amantadine, and side effects were more common with benztropine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Adjunctive imipramine in the treatment of postpsychotic depression. A controlled trial.

Author: SirisS G, MorganV, FagerstromR, RifkinA, CooperT B

Depression symptom relief
No significant side effects

This study evaluated the effectiveness of imipramine for treating depression in patients with schizophrenia or schizoaffective disorder. Imipramine was effective in reducing depressive symptoms without affecting psychotic symptoms.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

16.

Clinical experience in developing treatment regimens with the novel antipsychotic risperidone.

Author: KopalaL C

Improved long-term morbidity
Reduced extrapyramidal side effects
Reduces relapse risk
Extrapyramidal side effects

This study examined the effectiveness of risperidone in the treatment of patients with first-episode psychosis. Risperidone was effective in reducing psychotic symptoms at lower doses than those used to treat chronically ill patients, with a low incidence of extrapyramidal side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Different side effect profiles of risperidone and clozapine in 20 outpatients with schizophrenia or schizoaffective disorder: a pilot study.

Author: DanielD G, GoldbergT E, WeinbergerD R, KleinmanJ E, PickarD, LubickL J, WilliamsT S

Clozapine for schizophrenia
Sedation

Clozapine and risperidone have distinct side effect profiles. Risperidone was associated with more motor effects and insomnia, while clozapine was associated with more sedation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Study of penfluridol and chlorpromazine in the treatment of chronic schizophrenia.

Author: WangR I, LarsonC, TreulS J

Schizophrenia treatment
Extrapyramidal symptoms

Penfluridol, a once-a-week oral antipsychotic, was well tolerated and comparable to daily chlorpromazine in treating and maintaining schizophrenic patients.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

The effect of benztropine on haloperidol-induced dystonia, clinical efficacy and pharmacokinetics: a prospective, double-blind trial.

Author: GoffD C, AranaG W, GreenblattD J, DupontR, OrnsteenM, HarmatzJ S, ShaderR I

Dystonia prevention
Diminished sweat
Dry mouth

Moderate doses of benztropine were found to be effective in reducing dystonia in patients treated with haloperidol for acute psychosis. Benztropine did not significantly affect haloperidol blood levels or antipsychotic efficacy, and it was associated with a low incidence of anticholinergic side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

20.

Anticholinergic medication for antipsychotic-induced tardive dyskinesia.

Author: BergmanHanna, Soares-WeiserKarla

Tardive dyskinesia

Antipsychotic medication is associated with movement disorders. Anticholinergic drugs are used to reduce these side effects, but there is evidence that chronic anticholinergic use may cause tardive dyskinesia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Does cognitive function improve with quetiapine in comparison to haloperidol?

Author: VelliganDawn I, NewcomerJohn, PultzJoseph, CsernanskyJohn, HoffAnne L, MahurinRoderick, MillerAlexander L

Enhanced executive function
Enhanced verbal memory
Improved attention
Improved cognitive function
None mentioned

This study compared the effects of quetiapine and haloperidol on cognitive function in patients with schizophrenia. Results showed that patients receiving quetiapine 600 mg/day improved significantly on overall cognitive function, executive function, attention, and verbal memory compared to those receiving haloperidol.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Replacement of chronically administered anticholinergic drugs by amantadine in outpatient management of chronic schizophrenia.

Author: McEvoyJ P, McCueM, FreterS

Improved memory
EPSE

Amantadine, a non-anticholinergic drug, was found to be more effective than benztropine, an anticholinergic drug, in improving memory acquisition in patients with schizophrenia, although it may not be as effective in controlling extrapyramidal side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Benztropine for the relief of acute non-traumatic neck pain (wry neck): a randomised trial.

Author: AshaStephen Edward, KerrAndrew, JonesKeryn, McAlpineAnn

Improved range of motion
Reduced pain
Anticholinergic side effects

Benztropine was ineffective for reducing pain or improving range of motion of the cervical spine in patients suffering from acute, non-traumatic neck pain but frequently caused anticholinergic side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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