Benztropine (Cogentin®) is an anticholinergic drug principally used for the treatment of:

• Drug-induced parkinsonism, akathisia and acute dystonia;
• Parkinson disease; and
• Idiopathic or secondary dystonia.

Indications

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It is used in patients with schizophrenia to reduce the side effects of antipsychotic treatment, such as parkinsonism and akathisia.

Benztropine is also a second-line drug for the treatment of Parkinson's disease. It improves tremor but not rigidity or bradykinesia.

Benztropine is also sometimes used for the treatment of dystonia, a rare disorder that causes abnormal muscle contraction, resulting in twisting postures of limbs, trunk, or face.

Side effects

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These are principally anticholinergic:

• Dry mouth
• Blurred vision
• Cognitive changes
• Constipation
• Urinary retention
• Tachycardia
• Anorexia
• Psychosis (usually in overdose)

Some studies suggest that use of anticholinergics increases the risk of tardive dyskinesia, a long-term side effect of antipsychotics.^** Other studies have found no association between anticholinergic exposure and risk of developing tardive dyskinesia.^*

Anticholinergics | Dopamine reuptake inhibitors | Muscarinic antagonists | Tardive dyskinesia