Cogentin (Benztropine) Uses for Bipolar Disorder

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Medications often used to treat bipolar disorder, such as typical and atypical antipsychotic drugs, may cause drug-induced parkinsonism, the medical term for symptoms that mimic Parkinson's disease. 

Drug-induced parkinsonism may cause: 

  • A decrease in facial expressions
  • Difficulty starting and controlling movement
  • Slowed movement
  • Soft voice
  • Stiffness of the trunk, arms, or legs
  • Tremor

What Is Cogentin?

Cogentin (benztropine) is an antiparkinsonian drug in a class of drugs called anticholinergics. These drugs work by blocking a naturally occurring substance called acetylcholine. Cogentin improves muscle control and decreases the stiffness and tremors, and is therefore typically used in the treatment of Parkinson's disease and to control movement side effects of certain drugs such as those sometimes used in people with bipolar disorder.

Cogentin comes in 0.5, 1, and 2 mg tablets to be taken orally, usually at bedtime, but it may be taken multiple times a day to treat tremors. Your doctor may start you on a small dose to see how you respond. 

Contraindications

Cogentin may interact with certain drugs, including antidepressants, sleeping pills, painkillers, antihistamines, anti-diarrheal medications, some antacids, and other medications.

It's important that you speak with your doctor about any potential interactions. 

Common Side Effects 

The following are common side effects of ​Cogentin. You should check with your doctor if they don't go away or worsen:

  • Blurred vision 
  • Constipation 
  • Decreased sweating
  • Difficult or painful urination (especially in older men)
  • Drowsiness
  • Dryness of mouth, nose, or throat

Less Common Side Effects 

The following are less common side effects of Cogentin. 

  • Dizziness or lightheadedness when getting up from a lying down or sitting position
  • Euphoria
  • Headache
  • Memory impairments (especially in the elderly)
  • Nervousness
  • Stomach upset or pain
  • Unusual excitement

When to Contact Your Doctor

Always notify your doctor immediately if you experience these rare side effects of Cogentin:

  • Confusion
  • Eye pain
  • Skin rash
  • Rapid heart rate
  • Hallucinations

Overdose Effects

If you or a loved one have potentially overdosed on Cogentin, call your local poison control center and/or 911 immediately. Symptoms of overdose include:

  • Clumsiness or unsteadiness
  • Severe drowsiness 
  • Severe dryness of mouth, nose, or throat
  • Fast heartbeat
  • Hallucinations (seeing, hearing, or feeling things that are not there)
  • Mood or mental changes
  • Seizures
  • Shortness of breath or troubled breathing
  • Trouble sleeping
  • Warmth, dryness, and flushing of the skin

Other benztropine side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

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Article Sources

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  • Benztropine (Oral Route). Mayo Clinic (2015).

  • Psychiatric Medications: Benztropine. Stanford Medicine (2016).