Cogentin (benztropine) is a drug used as an adjunct therapy in Parkinson’s disease (PD) to treat tremors when they appear as a side effect of another medication. The drug often is used with antipsychotic drugs to prevent side effects, such as tremors and muscle rigidity.

How Cogentin works

Cogentin is an anticholinergic that works by decreasing the effects of acetylcholine. Acetylcholine is a neurotransmitter that is found at the junction between nerve cells and muscle cells.

Anticholinergic agents have different actions and clinical uses in various conditions; they decrease secretions from the nose and bronchi, as well as the production of saliva, tears, sweat, and gastric acid. They may be used to decrease secretions in allergic and inflammatory diseases. They help relax smooth muscle in the digestive system, bladder, and lungs and therefore have uses in gastrointestinal, urological or respiratory conditions associated with spasm and dysmotility.

Some anticholinergics help prevent motion sickness and nausea, and vomiting during surgeries. They also help reverse neuromuscular blockers used during anesthesia and may be used to treat slow heart rhythm bradycardia.

It is thought that Cogentin also increases the availability of dopamine, a naturally occurring chemical messenger in the brain the function of which is very important in the initiation and smooth control of voluntary muscle movement. (Low levels of dopamine in the brain have been associated with PD).

Other details

Cogentin comes as a tablet to be taken orally, or an injection solution. It usually is prescribed to be taken at bedtime.

The starting dose may be increased slowly with time, after observing response to the treatment. It should not be stopped suddenly because PD symptoms may return.

Common side effects include blurred vision, constipation, depression, dilated pupils, disorientation, dizziness, drowsiness, sleeplessness, dry mouth, fast heartbeat, hallucinations, headache, heat stroke, impaired memory, increased sensitivity to light, lightheadedness, loss of appetite, nausea, and upset stomach, nervousness, numbness of fingers, trembling of hands, urinary retention, and muscle weakness or stiffness.

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