Last reviewed:
23rd Nov 2022
PhD, OTR/L
Benztropine, sometimes known as benzatropine outside of the US, is an FDA-approved therapy for treating all forms of parkinsonism. You should always consult a medical professional before taking Benztropine as it can be addictive and may have adverse side effects.
Benztropine is available as a generic drug and also as a branded drug, under the name Cogentin.
Benztropine is most commonly used to treat different types of parkinsonism. Parkinsonism is a term used to describe symptoms of tremors, muscle rigidity, and slow movements. Parkinson’s disease is the most widespread type of parkinsonism, but there are other rarer types of parkinsonism that can be caused by things such as medication, progressive brain conditions, and cerebrovascular disease.[1]
Benztropine can also be used to treat drug-induced movement disorders, dystonic reactions, and acute dystonic reactions (involuntary contractions of muscles in the extremities such as the face, neck, abdomen, pelvis, or larynx) improving muscle control and reducing muscle stiffness.[2]
Benztropine works against acetylcholine and histamine receptors. In the CNS and smooth muscles, benztropine contends with acetylcholine at muscarinic receptors. By reducing central cholinergic effects it can improve the symptoms of Parkinson's disease.[3] It also blocks the effects of histamine in the brain, which does not serve the traditional function of managing allergies, rather it helps regulate cognition and arousal.
A dose of benztropine can be administered orally, intravenously, or through intramuscular routes. The oral route is preferred when addressing initial or acute symptoms of drug-induced parkinsonism. Benztropine therapy has cumulative effects so is often started with the lowest end of the dosages and may be gradually increased until optimal results are achieved. Oral doses are available in 0.5mg, 1mg, and 2mg and treatment usually starts with 0.5g, increasing up to 6mg over a period of up to 6 days.[2]
When administered orally, benztropine is gradually absorbed in the gastrointestinal tract and it reaches a peak concentration in around 7 hours. The elimination half-life of benztropine can vary significantly but is often around 36 hours.[4]
It is not uncommon to experience side effects from benztropine, but some milder symptoms may go away on their own. If any of the common side effects persist for a long period of time, or you experience any of the potentially serious side effects listed below, you should consult a doctor immediately.
Common side effects:
Potentially serious adverse reactions:
There are a number of precautions you should take before using Benztropine:
For the most part, benztropine should not be used if the patient has a history of sensitivity to benztropine mesylate or any component of the drug’s formula. Benztropine is contraindicated in patients with the following conditions:
Benztropine should be stored at room temperature, in a closed container, away from heat, moisture, and direct light. It also should not be frozen. Always keep medicine out of reach of children. Medicine that is out of date or no longer needed should be disposed of safely.[5]
In the case of a benztropine overdose, you should call the poison control helpline on 1-800-222-1222. Benztropine may cause an anticholinergic toxidrome, which may require supportive care. If the patient has collapsed, is seizing, is struggling to draw breath, or can’t be awakened you should call 911 immediately for medical attention.
Symptoms of a benztropine overdose can include:
Benztropine is not a benzodiazepine, it belongs to the anticholinergic drug class.
There are alternative medications for Parkinson's disease such as trihexyphenidyl and levodopa/carbidopa.[7] The mechanisms of these medications are different than those of benztropine but can still help with symptom management. Trihexyphenidyl is an antispasmodic, which will help with muscle rigidity and weakness. Levodopa increases dopamine in the brain to improve muscle flexibility and smoothness of movement.
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