Artane (trihexyphenidyl hydrochloride) is a well-established anticholinergic agent indicated for the management of parkinsonian symptoms, including tremors, rigidity, and sialorrhea. It functions by restoring the balance of neurotransmitters within the central nervous system, specifically counteracting the relative acetylcholine excess characteristic of extrapyramidal disorders. Clinicians frequently prescribe Artane as adjunctive therapy in Parkinson’s disease or to mitigate drug-induced extrapyramidal symptoms. Its efficacy in reducing muscular rigidity and improving functional mobility makes it a valuable option in neurological therapeutic regimens.

Features

• Active ingredient: Trihexyphenidyl Hydrochloride
• Available in 2 mg and 5 mg tablet formulations
• Also supplied as a 2 mg/5 mL elixir for flexible dosing
• Exhibits central anticholinergic activity
• Rapid absorption and onset of action
• Long-standing clinical use with well-documented profile

Benefits

• Reduces the frequency and severity of parkinsonian tremors
• Alleviates muscle rigidity, improving range of motion and mobility
• Decreases excessive salivation (sialorrhea), enhancing patient comfort
• Helps manage drug-induced extrapyramidal symptoms from antipsychotics
• Supports overall motor function and daily activity performance
• May contribute to reduced secondary complications from immobility

Common use

Artane is primarily used in the treatment of all forms of parkinsonism, including post-encephalitic, arteriosclerotic, and idiopathic Parkinson’s disease. It is also effectively employed to control extrapyramidal disorders that develop as a side effect of treatment with certain antipsychotic drugs, such as phenothiazines and butyrophenones. In some cases, it may be used off-label for dystonia or hyperhidrosis, under strict clinical supervision.

Dosage and direction

Dosage must be individualized based on therapeutic response and tolerability. For parkinsonism: Start with 1 mg on the first day, then increase by 2 mg increments at intervals of 3–5 days until a total of 6–10 mg per day is reached, usually given in 3–4 divided doses. Some patients may require up to 15 mg daily. For drug-induced extrapyramidal symptoms: 5–15 mg per day in divided doses. The elixir formulation allows for more precise titration. Administer with or after meals to minimize gastrointestinal upset.

Precautions

Use with caution in patients with glaucoma, prostatic hypertrophy, obstructive disease of the gastrointestinal or genitourinary tract, and cardiovascular disorders. Elderly patients may be more susceptible to confusion, agitation, or drowsiness. Artane may impair mental and/or physical abilities required for driving or operating machinery. Avoid abrupt discontinuation to prevent rebound cholinergic effects. Periodic reassessment of therapy is recommended to ensure continued need and appropriate dosing.

Contraindications

Artane is contraindicated in patients with known hypersensitivity to trihexyphenidyl or any component of the formulation. It is also contraindicated in patients with narrow-angle glaucoma, pyloric or duodenal obstruction, stenosing peptic ulcers, and significant bladder neck obstruction or prostatic hypertrophy. Should not be used in patients with myasthenia gravis or certain forms of cardiovascular instability.

Possible side effect

Common side effects include dry mouth, blurred vision, dizziness, nausea, and nervousness. Constipation, urinary hesitancy or retention, and increased intraocular pressure may occur. Some patients experience confusion, excitement, agitation, or hallucinations, especially at higher doses or in the elderly. Tachycardia, rash, and drowsiness have also been reported. Most side effects are dose-dependent and may diminish with continued therapy or dosage adjustment.

Drug interaction

Artane may interact with other drugs possessing anticholinergic properties (e.g., antihistamines, tricyclic antidepressants, some antiarrhythmics), potentially leading to additive effects and increased side effects. It may reduce the efficacy of neuroleptics and alter the gastrointestinal absorption of other drugs. Concomitant use with alcohol or other CNS depressants may enhance sedative effects. Use cautiously with MAO inhibitors. Always review the patient’s full medication list before prescribing.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one. Consistent dosing is important to maintain stable therapeutic levels and symptom control.

Overdose

Symptoms of overdose may include severe central nervous system disturbances (e.g., confusion, agitation, hallucinations), tachycardia, dilated pupils, hot and dry skin, and hyperthermia. In severe cases, respiratory depression, cardiovascular collapse, and coma may occur. Treatment is supportive and symptomatic; activated charcoal may be administered if ingestion was recent. Physostigmine may be used in severe cases under careful monitoring, but its use is controversial and should be managed in a critical care setting.

Storage

Store at room temperature (15–30°C or 59–86°F) in a tightly closed container, protected from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. For the elixir formulation, ensure the bottle is properly sealed and shaken well before each use.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or discontinuing any medication. Dosage and indications may vary based on individual patient factors and regional prescribing guidelines.

Reviews

Clinical studies and long-term use support the efficacy of Artane in managing parkinsonian symptoms and drug-induced extrapyramidal effects. Many clinicians appreciate its predictable pharmacokinetics and the flexibility offered by its multiple formulations. Some note that side effects, particularly anticholinergic effects, can be limiting in certain populations, necess careful dose titration. Patient responses vary, with some reporting significant improvement in tremor control and functional mobility, while others may experience tolerability issues. Overall, it remains a useful agent in neurological and psychiatric therapeutics.