there is no need to discontinue the tranquilizer or even to reduce the dosage
Cogentin advertisement, 1966.
Hospital & Community Psychiatry, Vol. 17, No. 2.

is his speech a little thick?
Thickened or slurred speech in the patient maintained on phenothiazines may herald serious extrapyramidal side effects. Other early signs and symptoms may be slight drooling, a fine tremor, slowed motor function, or apathy. These early effects, of course, can be transient and, if so, may be of no consequence to the patient.
If, however, they become serious or extremely bothersome to the patient, add Cogentin® Mesylate (benztropine mesylate) to the regimen. Cogentin usually relieves parkinsonian effects (muscular rigidity, gait disturbances, tremor at rest, drooling) as well as other extrapyramidal effects such as dystonia, akathisia, and akinesia. For most patients there is no need to discontinue the tranquilizer or even to reduce the dosage. INDICATIONS: Parkinson's disease; extrapyramidal reactions to phenothiazines or reserpine.
CONTRAINDICATIONS: None reported.
PRECAUTIONS: Supervision of patients is required. In severe reactions, discontinue drug or reduce dosage. Use with caution in hot weather to minimize risk of anhidrosis.
SIDE EFFECTS: These may be both anticholinergic and antihistaminic. Possible untoward reactions, usually dose-related, include: dryness of mouth, blurred vision, nausea, nervousness, glaucoma, vomiting, anhidrosis, muscular weakness, numbness of fingers, rash, dysuria, urinary retention, constipation, sedation, listlessness, depression, mental confusion, excitement, visual hallucinations, intensification of symptoms in patients with mental disorders who are receiving phenothiazine or reserpine medication.
BEFORE PRESCRIBING OR ADMINISTERING, READ PRODUCT CIRCULAR WITH PACKAGE OR AVAILABLE ON REQUEST.
Cogentin® Mesylate benztropine mesylate
Merck Sharp & Dohme ~ Division of Merck & Co., Inc., West Point, Pa.     where today's theory is tomorrow's therapy

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