Trihexyphenidyl [Artane] dependence: a controlled investigation between users and abusers

ABSTRACT

This controlled study aims to identify the socioclinical factors predisposing psychiatric patients to abuse trihexyphenidyI [artane] and to document the extrapyramidal symptoms in artane abusers and users. Thirty patients [n=30], with mainly two major functional psychoses and who were abusing trihexypenidyI, were compared with 90 artane user patients [n=90], who were mmatched for both the diagnosis and treatment. Besides a detailed clinical interview, ach patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involubatry Movement Scale. The analysis of data showed that, compared with users, trihexyphenidyI abusers were significantly characterized by being unmarried, unemployed, smokers 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 a longer basis. Besides other socioclinical parameters, premorbid personalities, stressful life vents and extrapyramidals, including tardive dyskinesias, we did not differentiate between the two groups. Artane abusers, when compared with users, were significantly characterized by less negative psychopathology. However, other psychopathological domains, in particular, the positive symptoms and depression, did not differentiate between abusers and users. In conclusion, patients having these soicoclinical profile tend to develop trihexyphenidyI abuse. The mental health pofessioals should not prescribe trihexyphenidyI indiscriminately or for a long time to such patients, who indeed require long-term antipsychotic maintenance medications