Biperiden as a cause of a cognitive decline – case reports

Abstract

Introduction
Anticholinergic drug biperiden is used to treat and prevent the extrapyramidal side effects of antipsychotic therapy. With its anticholinergic properties it affects cognitive functions, especially while concomitant drugs with anticholinergic effects are used.
Methods
We present a severe cognitive decline in four patients treated with 2 to 6 mg of biperiden daily.
Results
A significant improvement of 3 to 8 points on Mini mental state exam was noticed immediately after discontinuation of biperiden in patients with psychosis and dementia.
Conclusions
Biperiden is frequently prescribed, in spite of known deterioration of cognitive functions following its administration. In elderly patients even a small dosage of biperiden can cause a significant cognitive decline which can manifest as dementia – like a syndrome or worsening of actual dementia.