Are prophylactic antiparkinson drugs necessary? A controlled study of procyclidine withdrawal.
Of 55 aftercare patients receiving long-term treatment with antipsychotic and antiparkinson (AP) drugs, 37 were switched to being given placebo, and 18 remained on a regimen of procyclidine hydrochloride. The dose of antipsychotic was kept constant. After three weeks extrapyramidal side effects (EPS) developed in 54% of those patients receiving placebo and in none of those receiving procyclidine (P less than .002): Twenty-seven percent of the placebo group had EPS without akinesia, and in the same percentage akinesia developed (P = .003). We believe the risk-benefit ratio favors the routine use of AP drugs for prophylaxis and maintenance so as to avoid misdiagnosing as psychopathology, unspontaneity due to akinesia, and to reduce unreliable pill-taking due to EPS.
D000328:Adult; D000359:Aftercare; D001714:Bipolar Disorder / Q000188:drug therapy; D002746:Chlorpromazine / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000517:prevention & control*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000187:drug effects; D009068:Movement / Q000187:drug effects; D011352:Procyclidine / Q000627:therapeutic use*; D011759:Pyrrolidines / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000209:etiology*
D011759:Pyrrolidines; D011352:Procyclidine; D002746:Chlorpromazine