From the FDA Drug Label
DOSAGE AND ADMINISTRATION Benztropine mesylate tablets should be used when patients are able to take oral medication. ... Increases should be made in increments of 0. 5 mg, to a maximum of 6 mg, or until optimal results are obtained without excessive adverse reactions. Postencephalitic and Idiopathic Parkinsonism - The usual daily dose is 1 to 2 mg, with a range of 0. 5 to 6 mg orally or parentally. Drug-Induced Extrapyramidal Disorders - In treating extrapyramidal disorders due to neuroleptic drugs (e.g., phenothiazines), the recommended dosage is 1 to 4 mg once or twice a day orally, or parenterally.
The recommended benztropine doses are:
- Postencephalitic and Idiopathic Parkinsonism: 1 to 2 mg daily, with a range of 0.5 to 6 mg orally or parentally 1
- Drug-Induced Extrapyramidal Disorders: 1 to 4 mg once or twice a day orally, or parenterally 1, 1 The dose should be individualized according to the need of the patient, and increased gradually at five or six-day intervals to the smallest amount necessary for optimal relief. Key points:
- The maximum dose is 6 mg
- Increases should be made in increments of 0.5 mg
- The dose should be adjusted to obtain optimal results without excessive adverse reactions 1
From the Research
Benztropine is typically dosed at 1-2 mg orally once or twice daily for the treatment of Parkinson's disease and drug-induced extrapyramidal symptoms. For acute dystonic reactions, 1-2 mg can be given intramuscularly or intravenously. Treatment should start with lower doses (0.5-1 mg) in elderly patients and those who are more sensitive to anticholinergic effects. The maximum daily dose should not exceed 6 mg. Benztropine works by blocking cholinergic receptors in the central nervous system, which helps restore the balance between dopamine and acetylcholine in the basal ganglia. This medication should be taken consistently at the same time each day to maintain therapeutic levels. Patients should be monitored for anticholinergic side effects including dry mouth, blurred vision, constipation, urinary retention, and confusion. Benztropine should be used cautiously in patients with glaucoma, prostatic hypertrophy, or cognitive impairment, and should not be abruptly discontinued as this may worsen parkinsonian symptoms.
Some key points to consider when using benztropine include:
- The medication should be used with caution in patients with certain medical conditions, such as glaucoma or prostatic hypertrophy 2
- Benztropine can cause anticholinergic side effects, which can be problematic in elderly patients or those with certain medical conditions 3
- The medication can be effective in treating drug-induced parkinsonism, but may not be effective in treating other forms of parkinsonism, such as idiopathic Parkinson's disease 4
- Benztropine should not be used in combination with other medications that can cause anticholinergic effects, as this can increase the risk of side effects 5
It's also important to note that benztropine is not a disease-modifying treatment, but rather a symptomatic treatment that can help improve motor and nonmotor symptoms in patients with Parkinson's disease 2. Overall, benztropine can be a useful medication for treating Parkinson's disease and drug-induced extrapyramidal symptoms, but should be used with caution and under the guidance of a healthcare professional.