Trihexyphenidyl (Artane) Dependence: A Controlled Investigation between Users and Abusers

Abstract

This controlled study aims to identify the socioclinical factors predisposing psychiatric patients to abuse trihexyphenidyl (artane) and to document the extrapyramidal symptoms in artane abusers and users. Thirty patients (n=30), with mainly two major functional psychoses and who were abusing trihexyphenidyl, were compared with 90 artane user patients (n=90), who were matched for both the diagnosis and treatment. Besides a detailed clinical interview, each patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involuntary Movement Scale. The analysis of data showed that, compared with users, trihexyphenidyl abusers were significantly characterized by being unmarried, unemployed, smokers and having past and concurrent history of multiple drug abuse, and genetic loading of mental disorders. Both groups of patients were prescribed antipsychotic drugs and trihexyphenidyl on a longer basis. Besides other socioclinical parameters, premorbid personalities, stressful life events and extrapyramidals, including tardive dyskinesias, we did not differentiate between the two groups. Artane abusers, when compared with users, were significantly characterized by less negative psychopathology. However, other psychopathological domains, in particular, the positive symptoms and depression, did not differentiate between abusers and users. In conclusion, patients having these socioclinical profiles tend to develop trihexyphenidyl abuse. The mental health professionals should not prescribe trihexyphenidyl indiscriminately or for a long time to such patients, who indeed require long-term antipsychotic maintenance medications.

Suicidal and self-injurious behavior among patients with alcohol and drug abuse

“…In our two studies of psychiatric patients with trihexiphenidyl abuse, a similar pattern of smoking was also found 36,37…”

Trihexyphenidyl abuse in psychiatric outpatient clinic of a general hospital in Northern Nigeria

“…Schizophrenia is the commonest axis I diagnosis among THP abusers in this study but has no signifi cant relationship with THP misuse as reported in other studies elsewhere [20].…”

“…Abuse potential of the THP and other anticholinergice calls for caution in its prescription amidst other disadvantages. Easy availability, affordability and indiscriminate prescription will give serendipitous patients suffi cient time to realise the euphorigenic and addictive potentials of THP [20]. Anticholinergics should be tailed off after initial prescription of about 3-months to ease gradual cessation.…”

Smoking among Male Psychiatric Outpatients in Saudi Arabia

“…In contrast, in the rapidly developing Arabian Gulf countries, the literature on smoking in the general population is relatively scanty. In two studies of trihexyphenidyl abuse, 17,18 we found that 85.7% and 90% of studied patients were cigarette smokers. The main objectives of our study were: 1) to examine the probable prevalence and pattern of smoking among male psychiatric outpatients; and 2) to investigate the sociodemographic variables between smokers and nonsmokers.…”