Biperiden is used for the adjunctive treatment of all forms ofParkinson's disease (postencephalitic,idiopathic, and arteriosclerotic Parkinson's) and for reduced sweating inmethadone users. It seems to exert better effects in the postencephalitic and idiopathic than in the arteriosclerotic type.
Biperiden is also commonly used to improve acute extrapyramidal side effects related toantipsychotic drug therapy, such asakathisia.
In its role as a synthetic acetylcholine antagonist, biperiden has been analyzed as an alternative anticonvulsant for usage in the treatment of intoxication by organophosphorus nerve agents, such assarin.[12]
It was also suggested by IV route for neuroleptic malignant syndrome.[13]
Pregnancy : In animal studies biperiden had no embryo- or fetotoxic effects. There is no sufficient clinical data on pregnant women. The drug should therefore be used cautiously during pregnancy.
Lactation : Biperiden is found in the milk of lactating women. No sufficient clinical data exists regarding effects for the newborns. Additionally, biperiden may decrease maternal milk production. It is therefore recommended that biperiden is not used during lactation.
Children and adolescents aged 1 year and older may be treated. The clinical experience is mainly on the short-term treatment of acute drug induced dystonic reactions. Doses should be reduced according to the weight of the patients.[citation needed]
Caution: People with obstructive diseases of the urogenital tract, people with a known history of seizures and those with potentially dangeroustachycardia
Dose-dependentside effects are frequent. Particularly geriatric patients may react with confusional states or developdelirium.
CNS :Drowsiness,vertigo,headache, anddizziness are frequent. With high doses nervousness, agitation,anxiety, delirium, and confusion are noted. Biperiden may be abused due to a short acting mood-elevating and euphoriant effect. The normal sleep architecture may be altered (REM sleep depression). Biperiden may lower the seizure-threshold. Some instances of dementia have been noted to correlate with chronic administration ofanticholinergic medications such as biperiden forParkinson's disease.[14]
Peripheral side effects : Blurred vision, dry mouth, impaired sweating, abdominal discomfort, and obstipation are frequent. Tachycardia may be noted. Allergic skin reactions may occur. Parenteral use may cause orthostatic hypotension.
Eyes : Biperiden causesmydriasis with or withoutphotophobia. It may precipitate narrow angle glaucoma.
Biperiden mimics an atropine intoxication with mydriasis, dryness of mucous membranes, red face, atonic states of bowels and bladder, andhyperthermia in high doses. Central consequences are agitation, confusion, and hallucinations. An untreated overdose may be fatal, particularly in children. Premortal signs are respiratory depression and cardiac arrest. A specific antagonist isphysostigmine which combines a peripheral and a central action.Carbachol can be used to treat atonic bowels and bladder. The vital functions should be monitored and stabilized. It may be necessary to treat hyperthermia with cooling blankets.
Biperiden was synthesized by the German chemist W. Klavehn from Knoll AG, Germany. In March 1953 a patent was applied for in Germany[17] and subsequently in many other countries. A US patent application was filed in March 1954 and granted in April 1957.[18]
One website reported that it was not commercially available in the United States as of 2017.[19]
^abcdef"Biperiden Hydrochloride". The American Society of Health-System Pharmacists.Archived from the original on 21 December 2016. Retrieved8 December 2016.
^World Health Organization (2019).World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^Margetić B, Aukst-Margetić B (May 2010). "Neuroleptic malignant syndrome and its controversies".Pharmacoepidemiology and Drug Safety.19 (5):429–435.doi:10.1002/pds.1937.PMID20306454.S2CID2457321.
^Nishiyama K, Mizuno T, Sakuta M, Kurisaki H (1993). "Chronic dementia in Parkinson's disease treated by anticholinergic agents. Neuropsychological and neuroradiological examination".Adv Neurol.60:479–83.PMID8420174.
^abcdLakstygal AM, Kolesnikova TO, Khatsko SL, Zabegalov KN, Volgin AD, Demin KA, Shevyrin VA, Wappler-Guzzetta EA, Kalueff AV (May 2019). "DARK Classics in Chemical Neuroscience: Atropine, Scopolamine, and Other Anticholinergic Deliriant Hallucinogens".ACS Chem Neurosci.10 (5):2144–2159.doi:10.1021/acschemneuro.8b00615.PMID30566832.
