Artane (trihexyphenidyl hydrochloride) is a well-established anticholinergic agent indicated for the management of parkinsonian symptoms, including tremors, rigidity, and sialorrhea, and for the treatment of drug-induced extrapyramidal reactions. It functions by restoring the balance between acetylcholine and dopamine in the central nervous system, providing symptomatic relief and improving functional mobility. This medication is a cornerstone in adjunctive therapy for Parkinson’s disease and is critically valuable in mitigating the adverse motor effects associated with antipsychotic medications.

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
• Onset of action typically within 1 hour post-administration
• Demonstrated efficacy in reducing tremors and muscle stiffness

Benefits

• Significantly reduces the amplitude and frequency of parkinsonian tremors, enhancing manual dexterity
• Alleviates muscle rigidity, leading to improved range of motion and gait stability
• Decreases excessive salivation (sialorrhea), improving comfort and reducing aspiration risk
• Mitigates acute dystonic reactions and other extrapyramidal symptoms induced by neuroleptic drugs
• Supports overall functional independence and quality of life in patients with motor disorders
• Allows for better tolerability of antipsychotic regimens by controlling their motor side effects

Common use

Artane is primarily prescribed for the symptomatic treatment of all forms of parkinsonism, including post-encephalitic, arteriosclerotic, and idiopathic Parkinson’s disease. It is also extensively used to counteract extrapyramidal symptoms that may arise from therapy with antipsychotic drugs such as phenothiazines and butyrophenones. In clinical practice, it is sometimes employed off-label for the management of focal dystonias and sialorrhea unrelated to parkinsonism, though such use should be carefully supervised by a neurologist.

Dosage and direction

Dosage must be individualized based on therapeutic response and tolerability. For parkinsonism: Initiate with 1 mg on the first day, 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 in patients sensitive to anticholinergic effects. Administer with meals to minimize gastrointestinal upset. Do not crush or chew extended-release formulations if applicable.

Precautions

Use with caution in patients with glaucoma, prostatic hypertrophy, obstructive disease of the gastrointestinal or genitourinary tracts, and cardiac arrhythmias. Elderly patients are more susceptible to confusion, agitation, and hallucinations; initiate at lower doses. May impair mental and/or physical abilities required for hazardous tasks; advise against driving or operating machinery until response is known. Periodic intraocular pressure monitoring is recommended in patients with a history of glaucoma. Abrupt discontinuation should be avoided to prevent rebound cholinergic effects.

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 achalasia. Should not be used in patients with myasthenia gravis or those experiencing obstructive uropathy.

Possible side effect

Common adverse reactions include dry mouth, blurred vision, dizziness, nausea, and nervousness. Constipation, urinary hesitancy or retention, and increased intraocular pressure may occur. Less frequently, patients may experience confusion, hallucinations, tachycardia, and skin rashes. Paradoxically, excessive sweating may be noted in some cases. These effects are often dose-dependent and may diminish with continued therapy or dose adjustment.

Drug interaction

Artane may interact additively with other anticholinergic drugs, increasing the risk of adverse effects. Concurrent use with amantadine may enhance anticholinergic side effects. It may decrease the efficacy of levodopa by delaying gastric emptying. Antacids and antidiarrheals may reduce absorption of Artane. Use with CNS depressants (alcohol, benzodiazepines, opioids) can exacerbate sedation. MAO inhibitors may intensify anticholinergic effects. Always review the full medication profile before initiation.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly 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, as this increases the risk of anticholinergic toxicity.

Overdose

Symptoms of overdose may include severe central nervous system disturbances (agitation, confusion, hallucinations, seizures), tachycardia, hyperthermia, dilated pupils, dry skin, and respiratory depression. Management is supportive and symptomatic: gastric lavage if ingestion is recent, activated charcoal, and physiostigmine salicylate may be considered in severe cases under strict medical supervision. Maintain airway and provide respiratory support if necessary.

Storage

Store at controlled room temperature (20°–25°C or 68°–77°F), in a tightly closed container, and protect from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Dispose of unused medication via a drug take-back program or according to local regulations.

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. Do not disregard professional medical advice or delay seeking it based on content provided here. Individual medical conditions and responses to therapy vary.

Reviews

Clinical studies and long-term use support the efficacy of Artane in managing parkinsonian symptoms and drug-induced extrapyramidal effects. Many patients report significant improvement in tremor control and mobility. However, side effects, particularly dry mouth and blurred vision, are frequently noted. Neurologists often emphasize the importance of careful dose titration to balance benefits and tolerability. Patient experiences vary, with some achieving excellent symptom control, while others may discontinue due to adverse effects or insufficient response.