Benzatropine

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Benzatropine
File:Benztropin.png
Systematic (IUPAC) name
(3-endo)-3-(diphenylmethoxy)-8-methyl-8-azabicyclo[3.2.1]octane
Clinical data
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration
Oral, IM, IV
Identifiers
CAS Number 86-13-5
ATC code N04AC01 (WHO)
PubChem CID 1201549
DrugBank DB00245
ChemSpider 16736541
Chemical data
Formula C21H25NO
Molar mass 307.429 g/mol[[Script error: No such module "String".]]
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Benzatropine (INN), also known as benztropine (USAN, BAN), is an anticholinergic marketed under the trade name Cogentin which is used in the treatment of Parkinson's disease, parkinsonism, akathisia, and dystonia.

Indications

Benzatropine is used in patients 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 and rigidity but not 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

These are principally anticholinergic:

While some studies suggest that use of anticholinergics increases the risk of tardive dyskinesia (a long-term side effect of antipsychotics)[1][2], other studies have found no association between anticholinergic exposure and risk of developing tardive dyskinesia.[3]

Pharmacology

Benztropine is a centrally acting anticholinergic/antihistamine agent resulting from the combination of the tropine portion of the atropine molecule and the benzohydryl portion of diphenhydramine. Animal studies have indicated that anticholinergic activity of benztropine is approximately one-half that of atropine, while its antihistamine activity approaches that of mepyramine. Its anticholinergic effects have been established as therapeutically significant in the management of parkinsonism. Benztropine antagonises the effect of acetylcholine, decreasing the imbalance between the neurotransmitters acetylcholine and dopamine, which may improve the symptoms of early Parkinson's disease. [4] Benztropine also acts as a dopamine reuptake inhibitor, which may further substantiate its efficacy in treating Parkinson's.[5]

References

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de:Benzatropin fr:Benzatropine
  1. "Arch Gen Psychiatry -- Abstract: Tardive dyskinesia: prevalence and risk factors, 1959 to 1979, April 1982, Kane and Smith 39 (4): 473". Retrieved 2007-08-14. 
  2. Wszola BA, Newell KM, Sprague RL (2001). "Risk factors for tardive dyskinesia in a large population of youths and adults". Experimental and clinical psychopharmacology. 9 (3): 285–96. doi:10.1037/1064-1297.9.3.285. PMID 11534539. 
  3. van Harten PN, Hoek HW, Matroos GE, Koeter M, Kahn RS (1998). "Intermittent neuroleptic treatment and risk for tardive dyskinesia: Curaçao Extrapyramidal Syndromes Study III". The American journal of psychiatry. 155 (4): 565–7. PMID 9546009. 
  4. MIMS Australia Pty Ltd. MIMS.
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