<p>Anticholinergics by themselves commonly have sedative effects. The reason you read about benztropine being used is that it has dopaminergic activity as well (in addition to anticholinergic activity). Specifically, <a href="https://en.wikipedia.org/wiki/Benzatropine" rel="nofollow noreferrer">benztropine</a> and its derivatives are also dopamine reuptake inhibitors.</p>
<p>So from the perspective that benztropine is a dopamine reuptake inhibitor, i.e. a stimulant in the traditional sense, it would probably be a bad idea to use as a treatment for catatonia. If I remember right, its particular binding affinity is significant at the dopamine transporter.</p>

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2020-07-27T19:44:00.680Z
2020-08-04T20:39:30.803Z
2020-08-04T20:39:30.803Z
Mathemaphysics
<p>I found an <a href="https://pubmed.ncbi.nlm.nih.gov/2018827/" rel="nofollow noreferrer">old paper</a> describing a case study where a catatonic patient was successfully treated with benztropine (Cogentin). However, I can't find any modern guidelines that calls for this treatment (first-line is usually benzodiazepams). Is there any reason not to use anticholinergics for catatonia treatment?</p>
<p>Sources:</p>
<ol>
<li>Albucher RC, DeQuardo J, Tandon R. Treatment of catatonia with an anticholinergic agent. Biol Psychiatry. 1991;29(5):513-514. doi:10.1016/0006-3223(91)90281-p</li>
<li>Francis A. Catatonia: diagnosis, classification, and treatment. Curr Psychiatry Rep 2010; 12:180.</li>
</ol>

<psychiatry><psychopharmacology><drugs><pharmacopsychiatry>
Can anticholinergics like benztropine be used to treat Catatonia?
D.Tan
# Can anticholinergics like benztropine be used to treat Catatonia?

(Asked by: username_0 on 2020-07-26)

I found an [old paper](https://pubmed.ncbi.nlm.nih.gov/2018827/) describing a case study where a catatonic patient was successfully treated with benztropine (Cogentin). However, I can't find any modern guidelines that calls for this treatment (first-line is usually benzodiazepams). Is there any reason not to use anticholinergics for catatonia treatment?

Sources:

1. Albucher RC, DeQuardo J, Tandon R. Treatment of catatonia with an anticholinergic agent. Biol Psychiatry. 1991;29(5):513-514. doi:10.1016/0006-3223(91)90281-p
2. Francis A. Catatonia: diagnosis, classification, and treatment. Curr Psychiatry Rep 2010; 12:180.

**Tags:** psychiatry, psychopharmacology, drugs, pharmacopsychiatry


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## 1 answers

### Answer by username_1 on 2020-07-27. Score: 2 | Accepted answer

Anticholinergics by themselves commonly have sedative effects. The reason you read about benztropine being used is that it has dopaminergic activity as well (in addition to anticholinergic activity). Specifically, [benztropine](https://en.wikipedia.org/wiki/Benzatropine) and its derivatives are also dopamine reuptake inhibitors.

So from the perspective that benztropine is a dopamine reuptake inhibitor, i.e. a stimulant in the traditional sense, it would probably be a bad idea to use as a treatment for catatonia. If I remember right, its particular binding affinity is significant at the dopamine transporter.


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