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Hello All,

Looking for an opinion on something. I was put on Cogentin (Benztropine) 50mg a day for a neuroleptic crisis some years back. Almost immediately, I had visual hallucinations and even reported them to the nurse, who ignored it. Things spiraled out from there and my bizarre behavior got largely ignored, thanks to being under-insured. Eventually, I developed a heart arrhythmia so I was required to cold-turkey it. I don't wish benzodiazepine withdrawal syndrome on anyone. I had been on the medicine as well as narcotic-vicodin for about a year at that point. However, it made me wonder if having a paradoxical reaction to that specific hypnotic might be related to an underlying diagnosis? 

My entire nuclear family, save for myself, each has at least three comorbid conditions a peice. They have all gone to years of therapy but I guess for not wanting to throw flame onto a burning trash fire, I was excluded. As a side note, I was also one of the kids who got placed in the drug trial for Ritalin--for adhd which my mother was told I didn't really have. I also ended up in the open market trial for Abilify some ten years ago, unknowingly. Ritalin made me catatonic and depressed. Abilify was a rather similar experience to Ritalin, except I also experienced anhedonia and dissociation. So technically that's three poor responses to frontline medicines... 


Any thoughts would be appreciated. 

Edited by hypoElectron
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Congetin is an strong anticholinergic, which is usually used for EPS from neuroleptics. It's not a benzo.

That sounds like anticholingeric toxicity.

PDF warning

https://www.mdpoison.com/media/SOP/mdpoisoncom/ToxTidbits/2016/June 2016 ToxTidbits.pdf

Anticholinergic tox-icity, due to overdose or therapeutic misadventure, can result in a range of clinical signs and symptoms. The central nervous system (CNS) effects may be the most pronounced and include garbled speech, hallucinations, delirium, agitation and infrequently, seizures.

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Cogentin is not a benzo at all. Far from it. It sounds like a toxic reaction to the strong anticholinergic. It is why I don't recommend it, there are plenty of other meds for movement disorders. I have long said cogentin is nasty.

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  • 2 weeks later...

Thank you so much for your responses, A+N. Perhaps I misunderstood because of the name. Could have sworn someone also told me that it was. To be fair it did stop my dystonia but at way to high of a cost. Interestingly, they say promethazine is also of the same class. Just prior to being admitted to the hospital for this event I had been injected at a Urgent Care with a dose of that and sent home with Zofran pills to keep taking. Now I know Zofran triggers a generalized dystonic attack currently. Perhaps, this was a medical error thus a minor attack became a major one. 

Most of my neurological problems have died down to quite minor levels or respond well to lifestyle changes. (Avoiding strobe lights/No stimulants) It was rather annoying my neurologist and he had become convinced my issues were secondary to some umbrella disease. Having been in the hospital for three days this week, we may in fact have uncovered it. So now I have to sort of reset my frame of mind around it and question where my symptoms are really coming from, Including psychological problems.


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