Biperiden-Induced Delirium in an Adolescent Patient

Wang, Liang‐Jen; Sun, Chia-Ling; Huang, Yue

doi:10.1089/cap.2011.0050

Cited by 4 publications

(1 citation statement)

References 11 publications

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“…Only two of our included studies had children participants and, in these studies, using oral oxybutynin and tolterodine was not associated with cognitive impairment in children 42 , 43 . Reports of biperiden, an M1 receptor antagonist, induced delirium in children and adolescents 44 , 45 and recommended more caution in using this drug in each age group.…”

Section: Discussionmentioning

confidence: 99%

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis

Naseri

Sadigh-Eteghad

Seyedi‐Sahebari

et al. 2023

Dement. neuropsychol.

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ABSTRACT. Anticholinergics (ACs) are among the most prescribed drugs. Investigating the impaired cognitive domains due to individual ACs usage is associated with controversial findings. Objective: The objective of this study was to investigate the effects of individual ACs on different aspects of cognitive function based on clinical trial studies. Methods: This systematic review was conducted following the PRISMA statement. A systematic search was performed in Embase, PubMed, Cochrane Library, Scopus, and Web of Science databases. Risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists and the meta-analysis was performed using the CMA software. Results: Out of 3,026 results of searching, 138 studies were included. A total of 38 studies that assess the cognitive impacts of scopolamine were included in the meta-analysis. Included studies reported cognitive effects of scopolamine, mecamylamine, atropine, biperiden, oxybutynin, trihexyphenidyl, benzhexol, and dicyclomine; however, glycopyrrolate, trospium, tolterodine, darifenacin, fesoterodine, tiotropium, and ipratropium were not associated with cognitive decline. Based on the meta-analyses, scopolamine was associated with reduced recognition (SDM -1.84; 95%CI -2.48 to -1.21; p<0.01), immediate recall (SDM -1.82; 95%CI -2.35 to -1.30; p<0.01), matching to sample (SDM -1.76; 95%CI -2.57 to -0.96; p<0.01), delayed recall (SDM -1.54; 95%CI -1.97 to -1.10; p<0.01), complex memory tasks (SDM -1.31; 95%CI -1.78 to -0.84; p<0.01), free recall (SDM -1.18; 95%CI -1.63 to -0.73; p<0.01), cognitive function (SDM -0.95; 95%CI -1.46 to -0.44; p<0.01), attention (SDM -0.85; 95%CI -1.38 to -0.33; p<0.01), and digit span (SDM -0.65; 95%CI -1.21 to -0.10; p=0.02). There was a high RoB in our included study, especially in terms of dealing with possible cofounders. Conclusion: The limitations of this study suggest a need for more well-designed studies with a longer duration of follow-up on this topic to reach more reliable evidence.

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Section: Discussionmentioning

confidence: 99%

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis

Naseri

Sadigh-Eteghad

Seyedi‐Sahebari

et al. 2023

Dement. neuropsychol.

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Effects of anticholinergic challenge on psychopathology and cognition in drug-free patients with schizophrenia and healthy volunteers

et al. 2014

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The anticholinergic intervention caused more pronounced psychopathological and cognitive deteriorating effects in patients suffering from schizophrenia than in healthy volunteers. This could be related to the disrupted cholinergic transmission in schizophrenia. Our findings speak on behalf of the need of a more restrictive use of anticholinergics in psychiatric patients. The age-related attenuation of PANSS score increases in patients could be related to the age-dependent changes in dopamine dynamics and also to the age-associated decline of the availability of muscarinic receptors. Our results emphasise the need for further investigation of cholinergic disturbances in schizophrenia.

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Biperiden-Induced Delirium In A Five-Years Old Child

Kınay

Soyata²

2019

CDS

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Objective: Extrapyramidal adverse effects of antipsychotic drugs are more reported in children. Biperiden is an anticholinergic agent to treat the adverse effects of antipsychotic drugs. The drug has the potential to induce delirium at toxic doses. However, data are scarce about delirium associated with biperiden in children. Thus far, a case of delirium has been associated with biperiden in an adolescent patient. We report the first case of delirium associated with the use of biperiden in a preadolescent patient. Case Report: A boy aged five years and weighing 20 kilograms had been diagnosed as having oppositional defiant disorder and separation anxiety disorder in the previous treatment center. Ten milligrams fluoxetine and 0.25 milligrams risperidone had been initiated. On the third day of treatment, dystonia developed and he was administered with biperiden. An hour later, he was brought to our emergency clinic due to disorganized speech and behavior. His vital signs were stable. There were no findings in blood and urine tests. No electrolyte imbalance, liver, kidney, and thyroid dysfunction have been observed. His neurologic examination was unremarkable and no abnormal findings were shown on cranial magnetic resonance imaging. No other system findings or findings pointing out to infectious diseases have been observed. One milligram physostigmine was administered with intravenous infusion. However, symptoms did not resolve and he was diagnosed with delirium. Naranjo Adverse Drug Reaction Probability Scale score was seven, indicating a “Probable” Adverse Drug Reaction. Half milligram haloperidol was administered bid for three days and he was discharged with complete recovery. Conclusion: Clinicians must be aware of the risk of delirium when using non-toxic doses of biperiden in young children.

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Biperiden-Induced Delirium in an Adolescent Patient

Cited by 4 publications

References 11 publications

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis

Effects of anticholinergic challenge on psychopathology and cognition in drug-free patients with schizophrenia and healthy volunteers

Biperiden-Induced Delirium In A Five-Years Old Child

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