Benztropine
Cogentin
AnticholinergicGeneric available
Clinical Pharmacology Benztropine mesylate possesses both anticholinergic and antihistaminic effects, although only the former have been established as therapeutically significant in the management of parkinsonism. Its anticholinergic activity is about equal to that of atropine.
Compare Benztropine →FDA-Approved Indications
- an adjunct in the therapy of all forms of parkinsonism
Common Off-Label Uses
- Dystonia (drug-induced)
- Drooling/sialorrhea
What Sets This Drug Apart
- Anticholinergic agent specifically for treating or preventing antipsychotic-induced EPS — not an antipsychotic or antidepressant
- First-line for acute dystonia: 1-2 mg IM/IV with onset in 5-15 minutes; PO maintenance for ongoing EPS prophylaxis
- Anticholinergic side effects (dry mouth, urinary retention, constipation, cognitive impairment) are significant, especially in elderly
- Routine prophylactic use with antipsychotics is debated; generally reserved for high-potency FGAs or patients with prior EPS history