Eastern J Med. 2018; 23(3): 225-228 | DOI: 10.5505/ejm.2018.41275

Anticholinergic Delirium Superimposed On Severe Cognitive Deficit Secondary to Benzhexol and Flupenthixol Decanoate: A Dilemma In Management.

Siti Nor Fadhlina Misron¹, Zahiruddin Othman², Lukmanul Hakim Misron^3
1Department of Psychiatry, Hospital Tawau, Peti Surat 67, 91007 Tawau, Sabah, Malaysia
²Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia
³Department of Anaesthesiology, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia

The first and second generation antipsychotics are associated with cognitive impairment through the antidopaminergic and anticholinergic effects. However serious anticholinergic adverse events may occur in susceptible individual, such as being illustrated in this case, even though flupenthixol decanoate has never been reported to cause them. The concomitant use of anticholinergic medication to counter the antidopaminergic side effects may further accentuate this condition and leads to delirium despite within the therapeutic dosage.

Keywords: Anticholinergic delirium, cognitive deficit, flupenthixol decanoate, benzhexol

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