Stopping Unneeded Anticholinergic Drugs in Schizophrenia Patients
Tests stopping unneeded benztropine or trihexyphenidyl in adults with schizophrenia.
Plain-language title generated from the registry record
Registry title: Anticholinergic Deprescription in Schizophrenia
Key facts
- Where
- Pittsburgh, United StatesSee the site
- Phase
- Phase 4
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 40 and 70 years old?
Source: NCT06562608, who can take part
Where in United States
- UPMC Western Psychiatric Hospital/University of PittsburghPittsburgh, United StatesTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Deepak K. Sarpal, M.D.
- Trial code
- NCT06562608
- Record updated
- 10 July 2026
- Original description
In this study, the investigators will examine whether a deprescription of unnecessary anticholinergic drugs (benztropine or trihexyphenidyl) can augment quality of life, functioning, and neurocognition in individuals who with schizophrenia. Individuals identified by clinical services who have unneeded prescriptions benztropine or trihexyphenidyl will be eligible for deprescription and study entry. Following a baseline evaluation and magnetic resonance imaging (MRI), participants will will be randomized to either staying on their anticholinergic drugs or undergoing deprescription per routine clinical care, and will undergo follow-up evaluations across 6 months. The investigators predict that reducing and deprescribing these drug, if clinically determined to be unnecessary will will enhance functioning, neurocognitionRead full original descriptionShow less
Neural Mechanisms of Anticholinergic Burden in Mid- to Late-Life Schizophrenia Spectrum
In this study, the investigators will examine whether a deprescription of unnecessary anticholinergic drugs (benztropine or trihexyphenidyl) can augment quality of life, functioning, and neurocognition in individuals who with schizophrenia. Individuals identified by clinical services who have unneeded prescriptions benztropine or trihexyphenidyl will be eligible for deprescription and study entry. Following a baseline evaluation and magnetic resonance imaging (MRI), participants will will be randomized to either staying on their anticholinergic drugs or undergoing deprescription per routine clinical care, and will undergo follow-up evaluations across 6 months. The investigators predict that reducing and deprescribing these drug, if clinically determined to be unnecessary will will enhance functioning, neurocognition
Inclusion: Primary DSM-defined diagnosis of schizophrenia, schizoaffective disorder, or unspecified psychotic disorder, verified by the Structured Clinical Interview for DSM-5 (SCID); Prescription of benztropine or trihexyphenidyl for at least 6 months; Age 35-70 years; ACBS score >= 3; Mild or absent extrapyramidal symptoms (Determined by clinical pharmacists and prescribers); Competency and willingness to sign informed consent; Age 40-70 years; Competency and willingness to sign informed consent.
Exclusion: Patients concurrently treated with electroconvulsive therapy will be excluded because of its effects on cognition; Individuals currently taking anticholinergic medications for reasons other than SSD; Serious neurologic or medical condition/treatment that impacts the brain and Neurodegenerative conditions such as Parkinson's, dementia, etc.; autoimmune conditions such as Multiple Sclerosis (MS) and lupus; as well as traumatic brain injury (TBI); Current SCID-verified substance use disorder will be excluded to avoid the confounding impact of significant substance use comorbidity. Participants with a history of substance use disorder that is in early or full remission will be eligible, to enhance generalizability; No history of psychotic illness and no active Axis I disorder as determined by clinical interview using the SCID-NP; Neurologic conditions, any serious non-psychiatric disorder that could affect brain functioning, or intellectual disability; HC with family history of psychosis will be excluded, as such individuals show subtle, but significant cognitive and neurobiological abnormalities; Serious anticholinergic side-effects (e.g., fever, blurred vision) indicative of a need for immediate removal of anticholinergics,; Significant risk of suicidal or homicidal behavior; Cognitive or language limitations, or any other factor that would preclude subjects providing informed consent; Contraindications for MR imaging (e.g., a pacemaker); Score greater than 1 on the ACB scale; MR imaging contraindications.