IV is the route of choice, with signs and symptoms often resolving within 10 minutes. The medication can be delivered IM if an IV line cannot be established, but medications will take 30 min to be absorbed. More than 1 dose may be necessary for complete resolution of dystonia. By blocking striatal cholinergic receptors, may help in balancing cholinergic and dopaminergic activity. Although an antihistamine, also possesses significant anticholinergic properties.
Mechanism of action is identical to that of benztropine.
GABA-ergic neurons are inhibitory and antagonize excitatory dopaminergic neurons. Continue medication for 48-72 hours to prevent relapse. Arrange psychiatric follow-up care if patient has a dystonic reaction while taking neuroleptic medication. When continued neuroleptic therapy is necessary, maintain patient on an anticholinergic agent or switch to a neuroleptic less likely to produce an acute dystonic reaction. The varied clinical expressions of dystonia.