Side Effects of trihexyphenidyl: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Main Research Findings

Trihexyphenidyl, an anticholinergic drug, is commonly used to treat dystonia, a movement disorder characterized by involuntary muscle contractions. Research indicates that trihexyphenidyl can be effective in reducing dystonia symptoms and improving motor function, particularly in children with cerebral palsy who lack spasticity and have higher cognitive function. 10 , 14 However, trihexyphenidyl is associated with side effects that can limit its use. 7 It has also been found to be effective in treating dystonia in Costello syndrome, a rare genetic disorder. 3

Reasons for Side Effects

Trihexyphenidyl's side effects are attributed to its anticholinergic action, which blocks the action of acetylcholine, a neurotransmitter involved in various bodily functions such as muscle contraction, heart rate, digestive function, and memory. The disruption of acetylcholine's normal functions can lead to a range of side effects. 23 , 25

Common Side Effects

Constipation

Trihexyphenidyl can slow down bowel movements, leading to constipation. 10 , 12

Dry Mouth

Trihexyphenidyl can reduce saliva production, causing dry mouth. 10 , 12

Blurred Vision

Trihexyphenidyl can constrict the pupils of the eyes, resulting in blurred vision. 10

Urinary Retention

Trihexyphenidyl can inhibit bladder muscle contraction, potentially leading to urinary retention. 10

Dizziness

Trihexyphenidyl can affect the inner ear, which is responsible for balance, causing dizziness. 1

Drowsiness

Trihexyphenidyl can suppress the central nervous system, leading to drowsiness and dizziness. 22 , 1

Fever

Trihexyphenidyl can interfere with the thermoregulatory center, potentially causing fever. 20

Respiratory Depression

Trihexyphenidyl can suppress the respiratory center, potentially leading to respiratory depression. 15

Increased Heart Rate

Trihexyphenidyl can accelerate heart rate. 15

Arrhythmia

Trihexyphenidyl can disrupt the electrical activity of the heart, potentially causing arrhythmia. 15

Confusion

Trihexyphenidyl can lower the level of consciousness, potentially leading to confusion. 20

Countermeasures for Side Effects

Constipation

To prevent constipation, it's crucial to drink plenty of fluids and consume a diet rich in fiber. If necessary, consult a doctor for a prescription for laxatives. 10 , 12

Dry Mouth

Staying hydrated is essential for preventing dry mouth. Chewing xylitol-containing gum or tablets can help stimulate saliva production. 10 , 12

Blurred Vision

Blurred vision often improves upon discontinuing trihexyphenidyl. If it persists, seek an ophthalmologist for appropriate treatment. 10

Urinary Retention

Staying hydrated and avoiding holding urine for extended periods can help prevent urinary retention. Consult a doctor if necessary for medications that promote urination. 10

Dizziness

Rest and avoid exertion if you experience dizziness. Staying hydrated and limiting salt intake can also be beneficial. 1

Drowsiness

Drowsiness often subsides upon discontinuing trihexyphenidyl. Consult a doctor if drowsiness is severe to adjust the dosage. 22 , 1

Fever

Seek medical attention for fever. 20

Respiratory Depression

Seek immediate medical attention if you experience respiratory depression. 15

Increased Heart Rate

Consult a doctor if you experience an increased heart rate. 15

Arrhythmia

Seek immediate medical attention if you experience arrhythmia. 15

Confusion

Seek immediate medical attention if you experience confusion. 20

Comparison Between Studies

Similarities in Studies

A majority of studies indicate that trihexyphenidyl can be beneficial for treating dystonia and related symptoms. However, they consistently acknowledge the presence of side effects. 14 , 10 , 12 , 7 , 3

Differences in Studies

Variations exist in the efficacy and severity of side effects of trihexyphenidyl across different studies. For instance, the study in 10 highlights trihexyphenidyl's effectiveness in children without spasticity and with higher cognitive function. Conversely, the study in 14 didn't observe significant therapeutic benefits in children with cerebral palsy.

Precautions for Applying Research to Real Life

While trihexyphenidyl can be effective in improving dystonia symptoms, it's essential to be aware of the potential side effects. Before starting trihexyphenidyl, consult a doctor to understand the risks and benefits of side effects and make an informed decision. 14 , 10 , 12 , 7 , 3

Limitations of Current Research

Research on the effects and side effects of trihexyphenidyl is still limited. Long-term effects of trihexyphenidyl require further investigation. Additionally, careful use of this medication is necessary in certain groups, such as children, the elderly, and individuals with impaired kidney or liver function. 12 , 7

Future Research Directions

Further research is needed on the effects and side effects of trihexyphenidyl, particularly regarding its long-term impact and safety in specific populations. Developing new medications that enhance trihexyphenidyl's effectiveness and mitigate side effects is also a promising area of research. 2

Conclusion

Trihexyphenidyl can be a valuable treatment option for dystonia and related symptoms. However, it's crucial to be aware of the associated side effects and discuss them with your doctor. Before starting trihexyphenidyl, consider the risks and benefits to make an informed decision. 14 , 10 , 12 , 7 , 3

Literature analysis of 25 papers
Positive Content
20
Neutral Content
0
Negative Content
5
Article Type
3
0
0
3
23
1.

Double-blind crossover comparison of triazolam and lorazepam in the posthypnotic state.

Author: CohnJ B

Induces sleep
Daytime sleepiness
Side effects

Triazolam and lorazepam are both effective hypnotics, but lorazepam has more pronounced daytime carryover and 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

2.

Blockade of M4 muscarinic receptors on striatal cholinergic interneurons normalizes striatal dopamine release in a mouse model of TOR1A dystonia.

Author: DownsAnthony M, DonsanteYuping, JinnahH A, HessEllen J

DA release enhancement

This study investigated the mechanism of action of trihexyphenidyl (THP), a non-selective muscarinic receptor (mAChR) antagonist, in treating dystonia associated with TOR1A. The study found that THP acts in part at M4 mAChR on striatal cholinergic interneurons to enhance dopamine release.

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.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Treatment of Dystonia Using Trihexyphenidyl in Costello Syndrome.

Author: RomeoDomenico M, SpecchiaAlessandro, FasanoAlfonso, LeoniChiara, OnesimoRoberta, BrognaClaudia, VeltriStefania, ZampinoGiuseppe

Costello syndrome treatment

This case report describes the successful treatment of dystonic posture in a child with Costello syndrome (CS) using trihexyphenidyl. CS is a rare syndrome with significant musculoskeletal involvement, including dystonia. The findings suggest that pharmacological treatment with trihexyphenidyl may be a valuable option for managing movement and posture disorders in patients with CS.

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.

Language : English

4.

Waddling Gait: A complication of valproate therapy and a thought beyond vitamin D deficiency.

Author: SharmaAmit, SinhaSiddhartha, NarangAmit, ChouhanDushyant K, GuptaSumit

Muscle weakness treatment
Muscle weakness

Sodium valproate, an antiepileptic and antipsychotic drug, can cause proximal myopathy, which can be misdiagnosed as vitamin D deficiency. This case report describes a 13-year-old girl who developed proximal myopathy after taking sodium valproate. Her symptoms resolved after the drug was replaced with ethosuximide and she received carnitine supplementation.

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.

Language : English

5.

Anticholinergic medications for reducing drooling in children with developmental disability.

Author: ReidSusan M, WestburyChristine, GuzysAngela T, ReddihoughDinah S

Reduce drooling
Side effects

This study aimed to determine the effectiveness of three anticholinergic medications in reducing drooling in children with developmental disabilities, the frequency and nature of side effects, and their impact on treatment discontinuation.

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.

Language : English

6.

Trihexyphenidyl rescues the deficit in dopamine neurotransmission in a mouse model of DYT1 dystonia.

Author: DownsAnthony M, FanXueliang, DonsanteChristine, JinnahH A, HessEllen J

Increased dopamine release
Nicotinic receptor targets
Side effects

This study investigated the mechanism of action of trihexyphenidyl, a drug used for treating DYT1 dystonia. The study found that trihexyphenidyl increased striatal dopamine release in a mouse model of DYT1 dystonia, suggesting a potential role in normalizing dopamine regulation. The study also suggests that nicotinic receptors may be suitable therapeutic targets for DYT1 dystonia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
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

7.

Medication use in childhood dystonia.

Author: LumsdenDaniel E, KaminskaMargaret, TomlinStephen, LinJean-Pierre

Adverse drug responses

This study reviewed medications used to treat childhood dystonia and determined the prevalence of adverse drug responses (ADRs) resulting in discontinuation of drug use. The study also identified clinical risk factors for ADRs.

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

Language : English

10.

Trihexyphenidyl improves motor function in children with dystonic cerebral palsy: a retrospective analysis.

Author: Ben-PaziHilla

Improved functional improvement
Improved motor function
Reduced tone
Hyperopia

This retrospective analysis of 31 children with dystonia following treatment with high-dose trihexyphenidyl showed that trihexyphenidyl is effective particularly in the absence of spasticity and in children with higher cognitive abilities.

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.

Language : English

11.

Treatment of generalized dystonia.

Author: LubarrNaomi, BressmanSusan

DBS efficacy
Dystonia treatment
Intolerable side effects
Patient selection

Deep brain stimulation (DBS) is a treatment option for generalized dystonia.

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

Language : English

13.

Clinical research into Qufeng Zhidong Recipe used to treat 31 children with tic disorder.

Author: WuMin, XiaoGuang-Hua, ZhangJian-Ming, ZhangXin, MaBo, WangShu-Xia, ZhouYa-Bing, ZhangJing-Yan

Improved tic disorder

Qufeng Zhidong Recipe effectively relieves symptoms and signs of tic disorder in children without significant side effects.

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

14.

Pilot study on trihexyphenidyl in the treatment of dystonia in children with cerebral palsy.

Author: RiceJames, WaughMary-Clare

Improves upper limb function
Side effects

Trihexyphenidyl was assessed for its efficacy in reducing dystonia and improving upper limb function in children with dystonic cerebral palsy. This randomized, double-blinded, placebo-controlled, crossover trial found no significant treatment effects. Further research with larger trials and more narrowly defined functional levels is needed.

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

17.

Structure-activity relationship of trihexyphenidyl analogs with respect to the dopamine transporter in the on going search for a cocaine inhibitor.

Author: DarD E, ThiruvazhiM, AbrahamP, KitayamaS, KopajticT A, GamlielA, SlusherB S, CarrollF I, UhlG R

Cocaine inhibition
Side effects

This study investigated trihexyphenidyl (THP) analogs as potential cocaine inhibitors. Several analogs were found to block cocaine binding and enhance dopamine uptake. However, one analog that showed promise was ineffective as an in vivo cocaine inhibitor.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

19.

[Medical treatment of dystonia].

Author: KachiT

Dystonia treatment

This article discusses treatment options for dystonia, a neurological disorder characterized by involuntary muscle contractions. Botulinum toxin is a newer treatment, but its indications remain limited. Oral anticholinergic drugs are often recommended as first-line treatment, with diazepam being another option. The prognosis for dystonia, especially focal dystonia, is not hopeless.

English AbstractA summary of a research paper/publication written in English for a wider audience.
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 : Japanese

21.

Effects of selected anticholinergics on acoustic startle response in rats.

Author: SiposM L, BurchnellV, GalbickaG

Efficacious anticholinergic drug therapies
Side effects

Anticholinergic drugs can have different effects on the acoustic startle response in rats.

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

Language : English

22.

Haloperiodol-induced microcatalepsy differs in CD-1, BALB/c, and C57BL/6 mice.

Author: FowlerS C, ZarconeT J, VorontsovaE

model for extrapyramidal side effects

This study measured the degree of arrest of movement (microcatalepsy) induced by haloperidol in different mouse strains. The C57BL/6 strain exhibited greater susceptibility to microcatalepsy and sensitization to repeated dosing, which may serve as a model for genetic vulnerability to extrapyramidal motor side effects.

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.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

24.

Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective.

Author: BrocksD R

Treat Parkinson's disease
Peripheral side effects

Anticholinergic drugs are still used for the treatment of Parkinson's disease. These drugs are rapidly absorbed after oral administration with a bioavailability ranging from 30% to over 70%. While there is a lack of pharmacokinetic data for multiple dose administration and in the elderly, this may hinder the safe and effective use of these drugs in patients with Parkinson's disease.

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.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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