Betel nut-induced extrapyramidal syndrome: an unusual drug interaction.
Two cases are described of chronic schizophrenic patients maintained on depot neuroleptics, who developed severe extrapyramidal symptoms following a period of heavy betel nut consumption. A mechanism for this effect is proposed based on the pharmacological antagonism of the anticholinergic agent, procyclidine, by the active alkaloid ingredient of the betel, arecoline.
Deahl
M
M
Maudsley Hospital, Denmark Hill, London, England.
D014150:Antipsychotic Agents / Q000627:therapeutic use; D001114:Areca / Q000378:metabolism; D001115:Arecoline / Q000009:adverse effects; D001480:Basal Ganglia Diseases / Q000209:etiology* / Q000517:prevention & control; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010946:Plants, Medicinal / Q000378:metabolism; D011352:Procyclidine / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D011759:Pyrrolidines / Q000009:adverse effects*; D012559:Schizophrenia / Q000188:drug therapy; D014195:Travel; D006113:United Kingdom
D014150:Antipsychotic Agents; D011759:Pyrrolidines; D001115:Arecoline; D011352:Procyclidine