Trihexyphenidyl use and dependence: a case report

Abstract

Trihexyphenidyl is prone for abuse as well as dependence and produces a characteristic withdrawal syndrome. We present the case history of a 55-year-old lady who had an apparent worsening of her psychosis when trihexyphenidyl was withdrawn, and the dramatic resolution of her symptoms once it was re-introduced. Clinicians should consider such a presentation in patients with psychosis who are otherwise well maintained on antipsychotics. In view of the above as well as the known cognitive side effects of anticholinergic medications, long-term use of these agents should be avoided unless clearly indicated.

Keywords:

• anticholinergics
• trihexyphenidyl withdrawal
• dependence
• worsening of agitation