Objective: Evaluate cognitive performance in Parkinson’s disease patients receiving a low dose of trihexyphenidyl (THP).

Background: Before L-Dopa’s discovery, anticholinergic drugs were among the first treatments for Parkinson’s disease. THP is now only approved to treat unresponsive L-dopa tremors in young, cognitively unaffected Parkinson’s disease patients. However, there are no specific recommendations for disease duration, medication dose, or cognitive status. In low-income countries, THP is still frequently used in Parkinson’s disease patients with tremor.

Method: Nineteen PD patients performed the MoCA, of which nine patients were receiving THP. The patients were matched for age, disease severity, and duration

Results: The THP patients were taking an average dose of 3.3 mg of THP daily for an average of 1.8 years. There were no statistical differences between THP patients and non-THP patients in age (64.8 ­± 4.8 vs. 67.2 ± 6.9, p=0.4), UPDRS III (32.1 ±8.9 vs 41.5 ±20.6, p=0.2) and disease duration (6.2 ± 4.9 vs. 7.0 ± 4.0, p=0.7). The THP patients had lower cognitive performance, with a total MoCA of 19.22 ± 3.3 vs. non-THP patients 24.2 ± 3.0, p=0.003.

Conclusion: In Parkinson’s disease patients, even a low dose of THP causes significant cognitive loss.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/low-dose-trihexyphenidyl-use-causes-cognitive-dysfunction-in-parkinsons-disease-patients/