Cogentin, the drug name for benztropine, is a medication administered to people on antipsychotics as an adjunct therapy to reduce some of the side effects of these medications. Neuroleptic drugs that reduce the symptoms of psychosis sometimes cause movement disorders. Cogentin reduces muscle spasms, rigidity, tremors and restlessness associated with the longterm use of these medications. It is also used to treat similar symptoms in people with Parkinson's disease.
Dosage
The website Medicine Online notes that benztropine is sold as 0.5,1 and 2 mg tablets and recommends increasing the dose in 0.5 mg increments up to a maximum of 6 mg daily. Dosage is individualized for each patient so that optimum relief is achieved without causing adverse side effects. If movement disorders manifest acutely, benztropine can also be administered by injection. The website, rxmed, notes that the onset of action of benztropine is between one and two hours when administered orally and within minutes when given by injection.
Anticholinergic Drugs
Benztropine belongs to the class of drugs called anticholinergics. These drugs inhibit involuntary muscle contraction by blocking the effects of the chemical messenger acetylcholine. Multiple drugs, such as antihistamines, antidepressants, antipsychotics and muscle relaxants have significant anticholinergic activity. If a person is on more than one anticholinergic medication, the effects can be additive. Multiple anticholinergic drugs in combination or overdosage can cause acute anticholinergic syndrome. The symptoms of this syndrome include confusion, intensification of psychosis, dizziness, dry mouth, blurred vision, changes in heart beat, skin rash and nausea.
Gastrointestinal Side Effects
Because benztropine decreases contractions of involuntary muscles, it can cause gastrointestinal problems, such as dry mouth, nausea and constipation.
Tachycardia
Benztropine may cause a rapid heartbeat, also known as tachycardia.
Hyperthermia
Benztropine can stop sweating and a few reports exist of hyperthermia or heat stroke occurring in hot weather conditions and during exercise. Elderly patients and alcoholics have an increased risk of developing hyperthermia and heat stroke while taking benztropine.
Tardive Dyskinesia
Tardive dyskinesia is another type of movement disorder that may develop in patients on longterm neuroleptic treatment. This movement disorder is characterized by repetitive, involuntary movements such as lip smacking, tongue protrusion, rapid movement of the arms and legs and rapid eye blinking. Benztropine does not lessen the movement disorders of tardive dyskinesia,and the website, DailyMed reports that in some cases it may aggravate them.
Precautions
At high doses,benztropine can cause muscle weakness and central nervous system depression. It can enhance the effects of other central nervous system depressants,including alcohol, barbiturates, opioid pain relievers, neuroleptics and tricyclic antidepressants. Additionally, the drug label for Cogentin on DailyMed reports that in some instances it has intensified the symptoms of psychosis in mentally ill patients. Therefore,monitoring of patients on the combination of these medications is essential.
Member Comments