Toxic psychosis due to antiparkinsonian drugs

Antiparkinsonian drugs in the treatment of neuroleptic-induced extrapyramidal symptoms

Most patients on neuroleptic therapy experience extrapyramidal symptoms in one form or another during treatment. While the risk of extrapyramidal symptoms appears diminished with the newer and "atypical" neuroleptics (for example, risperidone, remoxipride, clozapine), it is not eliminated. It is essential that the treating clinician monitor for such side effects since if they are left untreated they can be an ongoing source of discomfort to the patient and may affect compliance with therapy. Antiparkinsonian medication represents the mainstay of treatment for neuroleptic-induced extrapyramidal symptoms. Their clinical use is reviewed here with reference to mode of action, indications, choice, side-effects and precautions.

Acute toxic psychosis in two children treated with benzhexol hydrochloride (Artane)

Although there have been reports of psychotic reactions to benzhexol hydrochloride in adults we have not found any reports of adverse reactions in children. Recently, at the in-patient psychiatric unit of the Hospital for Sick Children, Great Ormond Street, London, we have seen two children who developed acute psychotic reactions when treated with benzhexol hydrochloride given to prevent extra-pyramidal side effects. In both cases, complete recovery occurred rapidly when benzhexol was discontinued.