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Minerva Psichiatrica 1999 December;40(4):257-62

language: Italian

Anticholinergic abuse in psychiatry. A neglected problem

Oggioni A., Fioritti A.


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Neuroleptic medications often cause extra-pyramidal side effects (EPS). Since their introduction in psychiatric therapy, drugs used to treat EPS were reported to present risk of abuse. Nevertheless the problem has not been fully acknowledged by the psychiatric community. The current scientific literature is reviewed and discussed and is two personal experiences in the long-term psychopharmacological care of psychiatric patients with anticholinergic medications are reported. Between 1960 and 1997 more than 100 case reports, but just one clinical epidemiological study, appeared in the international literature. Data from the literature help to define risk factors. Two main groups of patients present higher probability of abuse: young schizophrenic patients looking for ''high'' effects and psychotic poly-drug abusers looking for psychedelic experiences. The abuse of anticholinergic drugs still represents a neglected problem in psychiatric practice. The need for a better recognition and treatment remains.

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