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Pharmacopsychiatry 2002; 35(1): 6-11
DOI: 10.1055/s-2002-19831
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Effects of Anticholinergic Drug Withdrawal
on Memory, Regional Cerebral Blood Flow and Extrapyramidal Side Effects in Schizophrenic Patients

K.  Mori1, 2 , H.  Yamashita2 , M.  Nagao1 , J.  Horiguchi3 , S.  Yamawaki2
  • 1Nagao Mental Hospital
  • 2Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine
  • 3Department of Psychiatry, Shimane Medical University School of Medicine, Japan
Further Information

Publication History

20. 7. 2000 · Revised 15. 1. 2001

10. 3. 2001

Publication Date:
30 January 2002 (online)

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It has been suggested that anticholinergic drugs impair immediate memory and working memory in patients with schizophrenia. Opinions remain divided as to the influence of anticholinergic drug withdrawal on the psychopathology and extrapyramidal side effects (EPS) in these patients. In our previous study, regional cerebral blood flow (rCBF) was reduced in all regions of patients taking anticholinergic drugs. Anticholinergic drugs were withdrawn in 21 schizophrenic inpatients. Immediate and verbal working memory, rCBF, psychopathology, and EPS were investigated before and after anticholinergic withdrawal. There was improvement in immediate memory, verbal working memory, and psychopathology, as well as an increase in rCBF after withdrawal from anticholinergic drugs. EPS showed no significant changes. Factors that may predict the improvement of immediate memory after withdrawal of anticholinergic drugs are more severe baseline psychopathology and use of a higher anticholinergic drug dose at baseline. Improvement of working memory may be predicted by a higher baseline rCBF in the left anterior cerebral artery region. Withdrawal from anticholinergics should be considered in schizophrenic patients, and it is important to taper these drugs over at least four weeks.

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MD, PhD Shigeto Yamawaki

Department of Psychiatry and Neurosciences
Hiroshima University School of Medicine

1-2-3 Kasumi, Minami-ku

Hiroshima 734-8551

Japan

Phone: ++81 822575207

Fax: ++81 822575209

Email: yamawaki@hiroshima-u.ac.jp