Misuse and Addiction to Trihexyphenidyl: Perception and Attitude of Tunisian Psychiatrists

Abstract

Introduction Trihexyphenidyl (THP) is an anti-Parkinson and anticholinergic drug, indicated in the treatment of parkinson disease, abnormal movements and parkinsonism induced by neuroleptic. The prophylactic use of anticholinergics in patients on neuroleptic treatment isn't recommended and may be justified only early in treatment. Howerver, in usual practice, the THP, is widely prescribed and used by patients. Recent observations suggest the existence of THP abuse linked to its hallucinogenic and euphoric effects. Aims to assess the tunisian psychiatrists perception on abuse and dependence potential of THP and their attitude toward this misuse. Methods A descriptive study among 100 tunisian psychiatrists (76: the public sector and 24: the private sector) who responded to a questionnaire, investigating the subject (dependence potential of THP, efficacy of THP, opinions about banning the THP from the tunisian pharmaceutical market). Results 87% of whole psychiatrists think that THP is associated with dependence potential. In the public sector, 77,63% of psychoatrists don't think that THP is more efficient than other anticholinergics and 78,94% agree to introduce other anticholinergic drugs in the hospital pharmacy. 3/4 of whole psychiatrists are for banning the THP from the national pharmaceutical market, espacially in the public sector, whose 80% of them approve the exclusion of THP from all public structures. Conclusions The majority of tunisian psychiatrists think that trihexyphenidyl is associated with a high risk of addiction. Many of them consider that banning THP and substitue it with other anticholinergics may be the solution. Is that really the best solution ?