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Adverse effects of anticholinergic medication on positive schizophrenic symptoms

Published online by Cambridge University Press:  09 July 2009

Eve C. Johnstone ,
Timothy J. Crow ,
I. Nicol Ferrier ,
Christopher D. Frith ,
David G. C. Owens ,
Rachel C. Bourne  and
Stephen J. Gamble
Eve C. Johnstone*
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Timothy J. Crow
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
I. Nicol Ferrier
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Christopher D. Frith
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
David G. C. Owens
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Rachel C. Bourne
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
Stephen J. Gamble
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex
*
1Address for correspondence: Dr E. C. Johnstone, Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex HA1 3UJ.
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Synopsis

In a series of 36 patients with acute schizophrenia flupenthixol dosage was blindly adjusted to give a fixed level of sedation. Patients were then randomly allocated to procyclidine or placebo. The patients receiving procyclidine experienced more positive schizophrenic symptoms and less severe extrapyramidal features by comparison with placebo patients. Blood levels of prolactin and flupenthixol estimated by radloimmunoassay were not significantly changed by the addition of procyclidine. Flupenthixol dosage and levels and prolactin levels were significantly related. There was no significant association between clinical and laboratory measures, with the exception that a curvilinear (inverted U) relationship was demonstrated between flupenthixol levels and antipsychotic and extrapyramidal effects. This relationship may be due to the fact that, in a study of this design, patients resistant to the effects of neuroleptic medication are likely to be given the highest doses. The findings support earlier claims that anticholinergic medication has adverse effects on schizophrenic symptoms.

Type
Research Article
Information
Psychological Medicine , Volume 13 , Issue 3 , August 1983 , pp. 513 - 527
Copyright
Copyright © Cambridge University Press 1983

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