Benzatropine is a drug in the anticholinergic drug class. It is used to treat motor movement disorders. Mainly, this agent is prescribed for Parkinson’s disease patients and movement disorders that occur as side effects of neuroleptics. Based on positive research results, clinical trials in multiple sclerosis are also being considered.
What is benzatropine?
Mainly prescribed for Parkinson’s disease patients and movement disorders that occur as side effects of neuroleptics. Pharmaceutically, benzatropine mesilate is used. It is the salt of benzatropine and methanesulfonic acid, which is formed from the reaction of these two substances. Benzatropine mesilate acts as a central anticholinergic. The main function of this drug is to restore the balance of the three important neurotransmitters dopamine, acetylcholine and glutamate in the brain, which is severely disturbed by Parkinson’s disease. This disturbance causes the typical accompanying symptoms of shaking palsy, such as tremor, lack of movement, muscle stiffness and motor disorders.
Pharmacologic action
The human brain exhibits a complex interconnected system of motor computational centers that ensures smooth movement and appropriate muscle activity without the person having to consciously think about these processes. The brain and the responsible neurotransmitters take into account not only depth sensitivity, the position and movement of joints, but also the emotionally predominant situation such as feeling and body language, for which the cortex of the cerebral cortex is responsible. With this complex system, humans are able to control their fine motor skills. Benzatropine is used to treat Parkinson’s disease patients. Although this disease of the central nervous system in the form of shaking palsy cannot yet be cured, the drug benzatropine has a positive effect on the accompanying complaints such as tremor, restricted movement, slowing of movement (bradykinesia), muscle rigidity, rigidity of movement, disturbance of the position and hold reflexes (postural instability) and unstable posture. Mild courses of the disease are often observed, which can be controlled so well with the drug that only minor limitations exist. However, for people whose profession makes them dependent on perfect fine motor skills, for example doctors or watchmakers, Parkinson’s disease can become an existential problem. Finding the right therapeutic approach is often not easy, since it is not clear how this shaking paralysis develops. Various factors can be triggers. Dopamine in its role as a messenger substance has a significant influence on the control processes of the musculoskeletal system. It is mainly formed in the special nerve cells of the brain, the so-called black substance (substantia nigra). The messenger substance activates movement via a complex control circuit. In a healthy brain, however, it also has a regulating effect on the cholinergic interneurons, which use dopamine as a transmitter. In the case of Parkinson’s disease, this dopamine inhibition is absent and the cholinergic interneurons are too active. If they fail, they cause Huntington’s disease and cause the failure of that area of the brain responsible for muscle control. Other neurotransmitters involved in movement control are acetylcholine as a neurotransmitter for regulating various movement processes and glutamate. Acetylcholine is mainly responsible for the transmission of excitation between nerves and muscles and acts as a transmitter within the central nervous system. Glutamate stimulates the striatum (striate body) of the cerebral hemisphere as a transmitter. In Parkinson’s disease, the nerve cells of the black matter die. Anticholinergics in the form of benzatropine counteract the imbalance of the neurotransmitters and reduce the symptoms, so that most patients can live well with their disease and their life expectancy is hardly limited.
Medical application and use
Benzatropine is used as an antiparkinsonian agent, for drug-induced Parkinson’s symptoms, sitting restlessness (akathisia), acute dystonia (neurologic movement disorder), secondary dystonia, and idiopathy (disease with an unclear cause). Benzatropine is an anticholinergic that has a balancing effect on the central nervous system.Anticholinergics are used in patients who are not older than 70 years and who have only mild symptoms. The main effect of this medication is to combat tremor, which is a major burden in everyday life for most patients. In this way, it is possible to treat the symptoms in the early stages of Parkinson’s disease. Patients take benzatropine in tablet form two to three times a day. Although it can cause some undesirable side effects and there are also contraindications to consider, benzatropine is a better choice compared to levodopa therapy. Because of the side effects, levodopa is not used in younger patients if possible, as treatment can only be given for a few years at a time.
Risks and side effects
Recorded side effects include: Dry mouth, vomiting, nausea, loss of appetite, intestinal obstruction, constipation, urinary retention, visual disturbances, pupil dilation, difficult urination, mental changes, slowed reaction, abnormal increase in body temperature, skin changes, and tachycardia (accelerated pulse). The following medical conditions form a contraindication: Cerebral palsy, toxic megacolon (chronic dilatation of the colon due to constipation), acute pulmonary edema, mechanical intestinal stenosis, narrow-angle glaucoma, tachyarrhythmia (cardiac arrhythmia), pyloric stenosis (narrowing of the gastric outlet), adhesions, ileus with obstruction in the stomach and intestines, paralytic ileus, severe ulcerative colitis (inflammatory bowel disease), hypersensitivity to any of the active ingredients of the drug and other anticholinergics. Caution in use is advised in patients over 65 years of age, pregnancy, or in children and patients prone to confusion and urinary retention. Review is equally advised in patients with cardiac arrhythmias, angina pectoris (chest tightness), and any condition that may cause an increased pulse rate, such as hyperthyroidism. An organic psychosyndrome may equally oppose the use of benzatropine. Heat exposure and decreased sweating may be equally dangerous in combination with this drug. Possible interactions also exist with tricyclic antidepressants and phenothiazines (neuroleptics).
