Thrihexyphenidyl abuse : a controlled investigation between users and misuses

Abstract EN

Objective: This controlled study aim to identify the socioclinical factors predisposing psychiatric patients to misuse trihexyphenidyl and to document the extrapyramidal features in both trihexyphenidyl (Artane) abusers and non-abusers.

Method: Thirty patients [n=30] with mainly two major functional psychoses and abusing trihexyphenidyl were compared with ninety Artane non-abusers patients [n=90| who were matched both for the diagnosis and treatment.

Besides detailed clinical interview, each patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involuntary Movement Scale.

Results: Comparatively, trihexyphenidyl abusers were significantly characterized by being ever-married, unemployed, smoking and having past and concurrent history of multiple drug abuse, and genetic loading of mental disorders.

Both groups of patients were prescribed antipsychotic drugs and trihexyphenidyl on long-term basis.

Besides other socioclinical parameters, premorbid personalities, stressful life events and extrapyramidal symptoms including tardive dyskinesia did not differentiate the two groups.

Artane abusers, when compared with non-abusers, were significantly less characterized by negative psychopathology.

However, other psychopathological domains including depressive and positive symptoms did not differentiate between abusers and non-abusers.

Conclusions: The patients having these socioclinical profiles tend to develop trihexyphenidyl abuse.

Psychiatrists should not prescribe trihexyphenidyl indiscriminately and for a long time to such patients, who indeed require long-term antipsychotic maintenance medications.