Benzatropine neuroleptic drugs

There were no changes in lithium pharmacokinetics when risperidone was substituted open-label for another neuroleptic drug in 13 patients (634). On the other hand, an 81-year-old man had an acute dystonic reaction 4 days after lithium was added to a regimen of risperidone, valproic acid, and benzatropine (635). 

A series of cases has been reported in which heat stroke occurred during hot weather, probably due to impaired heat adaptation in patients taking benzatropine and ethyl-benzatropine (544) this can occur with other anticholinergic and neuroleptic drugs as well. 

Benzatropine and ethylbenzatropine are particularly likely to interact additively with other drugs with both anticholinergic and antihistaminic activity, such as neuroleptic drugs complications such as hyperpyrexia, coma, and toxic psychosis have been reported several times when such combinations were used (626-628). 

Worsening parkinsonism was observed in two patients after treatment with olanzapine 5 mg/day (72). In contrast, coarse tremors induced by fluphenazine or haloperidol disappeared in three patients within days of the start of treatment with olanzapine (10 mg/day), without discontinuation or reduction in the dosage of fluphenazine or haloperidol (73). Olanzapine is active at muscarinic cholinergic receptors, which may account for the observed suppression of neuroleptic drug-induced tremor however, two of the three patients had been taking benzatropine, an antagonist at muscarinic acetylcholine receptors, with little tremor relief, suggesting that olanzapine could suppress tremor by means of an action other than muscarinic blockade. 

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See also in sourсe #XX -- [ ]

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