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To test the effect of prophylactic use of benzhexol in schizophrenia patients after risperidone treatment. Sixty-nine drug naïve schizophrenia patients were recruited. All patients were administered risperidone. Patients in the benzhexol group were given a benzhexol tablet of 2 mg bid daily. The controls received a placebo tablet of 2 mg bid daily. The primary outcome measured using the Extrapyramidal Symptoms Rating Scale (ESRS). The Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) measured secondary outcome. There were significant time and group effects on the ESRS scores of the two groups. The post hoc analysis yielded significant differences at 1, 2, 4, and 8 weeks between the two groups. There was a significant time effect on the PANSS scores of the two groups. No significant group and interaction effects on the PANSS scores of the two groups. There was a significant time effect on the BPRS scores of the two groups. No serious adverse events were found in this study. Prophylactic use of benzhexol reduced extrapyramidal symptom in schizophrenia patients after risperidone treatment and did not affect the antipsychotic action of risperidone.

The first and second generation antipsychotics are associated with cognitive impairment through the antidopaminergic and anticholinergic effects. However serious anticholinergic adverse events may occur in susceptible individual, such as being illustrated in this case, even though flupenthixol decanoate has never been reported to cause them. The concomitant use of anticholinergic medication to counter the antidopaminergic side effects may further accentu ate this condition and leads to delirium despite within the therapeutic dosage. [ABSTRACT FROM AUTHOR]

To test the effect of prophylactic use of benzhexol in schizophrenia patients after risperidone treatment. Sixty-nine drug naïve schizophrenia patients were recruited. All patients were administered risperidone. Patients in the benzhexol group were given a benzhexol tablet of 2 mg bid daily. The controls received a placebo tablet of 2 mg bid daily. The primary outcome measured using the Extrapyramidal Symptoms Rating Scale (ESRS). The Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) measured secondary outcome. There were significant time and group effects on the ESRS scores of the two groups. The post hoc analysis yielded significant differences at 1, 2, 4, and 8 weeks between the two groups. There was a significant time effect on the PANSS scores of the two groups. No significant group and interaction effects on the PANSS scores of the two groups. There was a significant time effect on the BPRS scores of the two groups. No serious adverse events were found in this study. Prophylactic use of benzhexol reduced extrapyramidal symptom in schizophrenia patients after risperidone treatment and did not affect the antipsychotic action of risperidone., Competing Interests: The authors declare no competing interests., (© 2023 Published by Elsevier Ltd.)

Objective. Recent observations in Iraq during the period of sanction suggest the existence of benzhexol prescribing linked to its calming effects on explosive behaviours. This inspired our group to research the existence of this practice and the characteristics of those involved in it. Method. All patients from the psychiatric service in Merjan Hospital, Al Hilla City, Babylon Governate, Iraq, who had a prescription for benzhexol between January 1991 and December 2000, were identified. All participants received their diagnosis based on the clinical criteria of the DSM-IV, after taking a comprehensive medical and psychiatric history, mental state examination and collateral information from family members. The patients were evaluated by the same qualified consultant psychiatrist at the initial assessment and all through the period of follow-up. Results. In the 10-year period under study, 354 patients were prescribed benzhexol. A total of 190 patients diagnosed as intermittent explosive disorder (IED) and 164 suffering from severe mental disorders or personality disorders were excluded from the study. The average age of the IED group was 29.5 years. On direct questioning, the main reason patients gave most frequently for using benzhexol was to control the aggressive outbursts (N=92, 48.4), to get high (N=49, 25.8), to relax (N=26, 13.7), to get rid of boredom (N=23, 12.1). In total, the whole group were prescribed benzhexol, at an average dose of 12.5 mg/day (range 2-20 mg/day). At the time of final assessment the mean dose of prescribed benzhexol had fallen slightly to 12 mg/day (2-20 mg/day), with 10 patients being benzhexol free. Of the 190, three patients had a diagnosis of obsessive compulsive disorders, 36 patients had a diagnosis of benzodiazepines dependence, and a further five had a diagnosis of alcohol dependency syndrome. Eighty percent felt satisfied with the effect of the drug and 95 were not motivated to stop it. Conclusions. There are a significant number of patients who are routinely prescribed benzhexol as a replacement therapy. The main original reason for starting it is to control outbursts and improves their reaction to stress situations. This growing issue raises the need for awareness, by both public and medical practitioners, of the potential adverse effects of benzhexol and its untoward consequences. [ABSTRACT FROM AUTHOR]

A mass-producible electro-chemiluminescence (ECL)-based sensor was constructed by immobilizing tris(bipyridine)ruthenium(II) (Ru(bpy)3 2+) on a carbon electrode using a screen-print (thick film) technique. The sensor was prepared by the following steps: First, the carbon ink was deposited to the epoxy substrate to form a conducting layer, then the mixture of carbon ink and Nafion-Ru(bpy)3 2+ composite was deposited onto the “working area” of this electrode. The last step was the formation of the Nafion protecting polymer on the electrode surface. The sensor was characterized with tri- n-propylamine (TPA) as a co-reactant. The results indicated that the sensor exhibited an excellent electrochemical performance and ECL behaviour with good stability. The applications of the sensor to the ECL determination of benzhexol and procyclidine is reported. [ABSTRACT FROM AUTHOR]

The neuroleptic malignant syndrome is a rare and potentially lethal reaction which is usually associated with the use of medications with antidopaminergic properties. This article describes the case of an elderly gentleman who developed the neuroleptic malignant syndrome after withdrawal of the anticholinergic agent benzhexol (trihexyphenidyl hydrochloride), which he was taking for Parkinson's disease. The patient improved rapidly after treatment was restarted. This case adds to the evidence that antidopaminergic agents may not be necessary for the development of this syndrome, and increased awareness of this possibility is advisable in such circumstances. [ABSTRACT FROM AUTHOR]