Choice | Drug | Dosage |
1st choice | Procyclidine tablets 5mg | Dose: See BNF - seek specialist advice |
Or | ||
Trihexyphenidyl hydrochloride tablets 2mg, 5mg | Dose: See BNF - seek specialist advice |
Prescribing Notes
- Antimuscarinics are sometimes used as a first line therapy in young onset Parkinson’s Disease under specialist supervision, but not generally recommended in older patients – see Cautions
- Antimuscarinics may occasionally be useful in patients with tremor which is unresponsive to other drugs, on the advice of a specialist
- Procyclidine is mainly used in the management of drug-induced parkinsonism
- Tardive dyskinesia is not improved by antimuscarinic drugs and may be made worse
Cautions
- Antimuscarinics may cause cognitive impairment and urinary retention. They should be avoided in older patients
- Antimuscarinics are not generally recommended for use in Parkinson’s Disease because of toxicity in the elderly and the risk of aggravating dementia
- Abrupt withdrawal of antimuscarinics should be avoided