Trihexyphenidyl (Artane) dependence: A controlled investigation between users and abusers

Area of Science:

• Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Trihexyphenidyl (artane) is commonly prescribed for antipsychotic-induced extrapyramidal symptoms.
• Substance abuse is a significant concern in psychiatric populations.
• Identifying risk factors for medication abuse is crucial for patient safety.

Purpose of the Study:

• To identify socioclinical factors associated with trihexyphenidyl abuse in psychiatric patients.
• To compare extrapyramidal symptoms between trihexyphenidyl abusers and users.
• To inform clinical practice regarding artane prescription.

Main Methods:

• Controlled study comparing trihexyphenidyl abusers (n=30) with matched users (n=90).
• Utilized clinical interviews, DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involuntary Movement Scale.
• Matched patients based on diagnosis and treatment for antipsychotics and trihexyphenidyl.

Main Results:

• Trihexyphenidyl abusers were significantly more likely to be unmarried, unemployed, smokers, have a history of multiple drug abuse, and possess a genetic loading for mental disorders.
• Abusers exhibited less negative psychopathology compared to users.
• No significant differences were found in other psychopathological domains, stressful life events, or extrapyramidal symptoms between the groups.

Conclusions:

• Specific socioclinical profiles predict trihexyphenidyl abuse in psychiatric patients.
• Indiscriminate or prolonged prescription of trihexyphenidyl should be avoided in at-risk individuals.
• Patients requiring long-term antipsychotic medication need careful management to prevent artane abuse.