Abuse Potential of Anticholinergics

Anticholinergics are widely used to treat extrapyramidal motor symptoms caused by neuroleptics or other drugs with antidopaminergic (dopamine D₂ ) effects. In the medical literature, occasional reports are concerned with the abuse of centrally acting anticholinergic compounds. These drugs may be abused because of their stimulant effects, mostly by patients on neuroleptic treatment. Their supposed “euphoric” effect when too quickly parenterally administered (only after previous treatment with neuroleptics) seems to consist in the abolition of neuroleptic-induced anhedonia. In a few patients, excessive use of anticholinergics persists in the face of detrimental effects and is, therefore, properly termed “abuse”. More commonly, however, patients with schizophrenia take more than the recommended dose of anticholinergics in an attempt to treat the adverse effects of neuroleptics. The abuse of anticholinergics in addicts who are not using neuroleptics is low.

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