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Trihexyphenidyl abuse in schizophrenic patient: a case report
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|February 1, 1996
Summary
This study highlights the abuse potential of trihexyphenidyl, an anticholinergic medication. Chronic schizophrenic patients may misuse it for euphoric effects, leading to adverse psychiatric and physical health outcomes.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Trihexyphenidyl is a synthetic anticholinergic medication prescribed for neuroleptic-induced extrapyramidal symptoms.
- It is known to possess mood-elevating and euphorigenic properties.
Observation:
- A case of chronic schizophrenic patient abusing high doses (up to 200 mg/day) of trihexyphenidyl for euphoric effects is presented.
- The patient obtained the drug partly through prescription and partly through over-the-counter purchase.
- Discontinuation led to anxiety, and the patient feigned symptoms to obtain anticholinergic injections during abstinence.
Findings:
- High-dose trihexyphenidyl abuse can precipitate anticholinergic toxic psychosis.
- Abuse may interfere with the absorption and therapeutic efficacy of antipsychotic medications.
- Withdrawal symptoms, including anxiety, necessitate anxiolytic treatment.
Implications:
- Clinicians must exercise caution when prescribing trihexyphenidyl, particularly to patients with a history of substance abuse.
- The widespread availability of trihexyphenidyl without public surveillance warrants concern regarding its abuse potential among vulnerable populations.
- Health authorities should consider enhanced monitoring and regulation of this medication due to its abuse potential.