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2024 August (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Trihexyphenidyl in the treatment of Drug induced parkinsonism

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Answer

Antipsychotic drugs produce drug-induced parkinsonism by blocking dopamine D2 receptors in the nigrostriatal pathway, tipping the normal dopamine-acetylcholine balance in the striatum toward relative cholinergic excess. Trihexyphenidyl, a centrally acting antimuscarinic, restores this balance by blocking the excess cholinergic activity — since the parkinsonism here is caused by dopamine blockade (not degeneration), restoring cholinergic balance directly relieves the extrapyramidal symptoms without needing to increase dopamine (which would counteract the antipsychotic itself).

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