Latest research on Benztropine

Benzotropine is a centrally-acting, antimuscarinic agent used as an adjunct in the treatment of Parkinson’s disease. It may also be used to treat extrapyramidal reactions, such as dystonia and Parkinsonism, caused by antipsychotics (e.g. phenothiazines). Symptoms of Parkinson’s disease and extrapyramidal reactions arise from decreases in dopaminergic activity which creates an imbalance between dopaminergic and cholinergic activity. Anticholinergic therapy is thought to aid in restoring this balance leading to relief of symptoms. In addition to its anticholinergic effects, benztropine also inhibits the reuptake of dopamine at nerve terminals via the dopamine transporter. Benzotropine also produces antagonistic effects at the histamine H1 receptor.

Latest findings

Benztropine was permitted up to 6 mg/d as needed for movement disorders; alternate medications allowed for acute extrapyramidal symptoms (EPS) were biperiden (up to 16 mg/d), Trihexyphenidyl (up to 15 mg/d), or Diphenhydramine (up to 100 mg/d). [source, 2016]
Medications with psychotropic activity were not allowed, with the following exceptions: Lorazepam for control of agitation, irritability, hostility, or restlessness; Zolpidem, Zaleplon, chloral hydrate, or Eszopiclone for insomnia; and Diphenhydramine, Benztropine, or Propranolol for EPS. [source, 2016]
Benztropine (4 mg) and Valium (2 mg) were prescribed to treat his neck stiffness, but these were not effective. [source, 2015]
To give an example, Turner and colleagues investigated if spinal cord injury patients and their study nurses/physicians were able to identify active pharmacological treatment (amiptriptyline) vs. active placebo (Benztropine which gives similar side effects) by asking them to identify treatment allocation at the end of the trial [16]. [source, 2015]
Intravenous Diphenhydramine 25 mg, Lorazepam 1 mg, and Benztropine 1 mg were sequentially administered to the patient for presumed dystonia. [source, 2015]
On the second day, Benztropine was added while Lorazepam was replaced with CLONAZEPAM. [source, 2015]
The following day, Risperidone, Benztropine, and fluoxetine were replaced with Olanzapine and Lorazepam. [source, 2015]
Benztropine (or benzatropine) is a potent DAT = NET inhibitor that exhibits only weak affinity for SERT (Table 1). [source, 2015]
The chemical formula of Benztropine is presented in Figure 5. [source, 2015]
In PD, Benztropine is primarily used as an anticholinergic agent [575]. [source, 2015]