Efficacy of Bethanechol in Antipsychotics Induced Anticholinergic Side Effects

Kim, Hyeong Seob; Yeo, Un Tae; Kim, So Hee; Joe, Sook Haeng

Abstract

OBJECTIVES
This study was designed to evaluate bethanechol's efficacy in urinary difficulty, constipation, dry mouth and blurred vision and to evaluate the bethanechol's effect on psychopathology.
METHODS
Thirty-two schizophrenic patients who have been treated with antipsychotics and the total score of anticholinergic side effect of 'Rating scale for side effect (no symptom ; 0, severe ; 3)' is above 5 were assigned to three group(controlled group, bethanechol 30 mg/day group, 60 mg/day group). These patients were entered on 6 weeks open trial. Anticholinergic side effects were assessed by 'Rating scale for side effect' and psychopathology by BPRS at base, 2nd week & 4th week. After 4weeks administration of bethanechol, 30 mg/day group was increase to 60 mg/day and 60 mg/day group was decreased to 30 mg/day for 2 weeks for evaluation of dose difference. And then anticholinergic side effects were reassessed at 6th week.
RESULTS
There were significant correlations between blurred vision and age. There were no significant improvement of anticholinergic side effect in placebo group but significant improvement of urinary difficulty and dry mouth in 30 mg/day group and significant improvement of urinary difficulty, constipation and dry mouth in 60 mg/day group at 4th week evaluation. In the case dose up(bethanechol 30 mg/day to 60 mg/day) for 2 weeks, dry mouth was more improved. In the case of dose down (60 mg/day to 30 mg/day), the improvements of urinary difficulty and dry mouth were sustained but constipation was aggravated. There were no BPRS changes by bethanechol administration.
CONCLUSION
These findings suggest that more than 30 mg/day of bethanechol made improvements in urinary difficulty, constipation, dry mouth, when the total score of Anticholinergic side effect of 'Rating scale for side effect (no symptom ; 0, severe ; 3)' is above 5, although 60 mg/day of bethanechol was more effective than 30 mg/day. Moreover bethanechol administration does not influence psychopathology.