Anticholinergic agent with antihistaminic properties
Blocks central cholinergic receptors to restore dopaminergic-cholinergic balance in extrapyramidal symptoms
Adjunctive treatment of parkinsonism and control of extrapyramidal symptoms (excluding tardive dyskinesia) induced by antipsychotics
Management of focal dystonias, prophylaxis of dystonia in high-risk individuals, and drug-induced parkinsonism
Oral tablets and injectable forms
Usually starts at 0.5 mg p.o. daily, titrated based on symptom control
0.5–2 mg/day, given once or twice daily
Well absorbed orally with peak plasma levels in 1–3 hours; metabolized hepatically and excreted renally
Dry mouth, constipation, urinary retention, blurred vision, confusion, and tachycardia
Cognitive impairment risk increases with age and higher doses
Monitor cognitive function and urinary symptoms, especially in elderly patients; assess for anticholinergic burden
None
Benztropine should be used with caution in patients with cognitive impairment, and regular reassessment, including trials of discontinuation, should be considered to minimize the risk of cognitive adverse effects and to ensure that ongoing therapy remains appropriate. It may be cautiously used in younger patients with extrapyramidal symptoms or as needed for acute dystonic reactions.