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Trihexyphenidyl, Biperiden, and Other Anticholinergics in the Treatment of Parkinson’s Disease

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NeuroPsychopharmacotherapy

Abstract

Anticholinergic drugs were the first pharmacological agents used to treat Parkinson’s disease (PD) and were primarily prescribed for parkinsonism until levodopa was marketed. Anticholinergics have been used for the treatment of Parkinson’s disease, neuroleptic-induced parkinsonism, and dystonia. The mechanism has not been fully understood, but it has been believed that blocking muscarinic acetylcholine receptors corrects the imbalance in the striatum between dopamine and acetylcholine. Anticholinergic agents, such as trihexyphenidyl (Artane®) and biperiden (Akineton®), are still used today. However, the usage is limited due to the potential unfavorable central and peripheral antimuscarinic effects and the development of various antiparkinsonian drugs. As monotherapy or adjunct therapy, anticholinergic drugs effectively improve motor function, such as tremor, and are an option for young cognitively unimpaired patients. Neuropsychiatric adverse events frequently occur, especially in older patients. Central toxic effects may lead to severe adverse events such as confusion, hallucination, delirium, and fracture caused by falls. The anticholinergic burden can cause a long-term adverse effect of increased risk for developing dementia.

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Authors and Affiliations

  1. Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Kazuya Kawabata & Masahisa Katsuno

Authors
  1. Kazuya Kawabata
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  2. Masahisa Katsuno
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Corresponding author

Correspondence to Masahisa Katsuno .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Bayern, Germany

    Christian Riederer

Section Editor information

  1. Center for Research Promotion and Support, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  2. Department of Physiological Chemistry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Akira Nakashima

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Kawabata, K., Katsuno, M. (2021). Trihexyphenidyl, Biperiden, and Other Anticholinergics in the Treatment of Parkinson’s Disease. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_221-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_221-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

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