Cholinergic rebound syndrome due to an antipsychotic

Cholinergic rebound syndrome can be caused by stopping or reducing the dose of an antipsychotic with significant anticholinergic properties, or switching to an antipsychotic with less anticholinergic properties. Symptoms are influenza-like (eg malaise, myalgia, rhinorrhoea); nausea, vomiting and agitation can also occur.

If cholinergic rebound syndrome occurs, reduce the rate of dose reduction. If this is ineffective or symptoms are severe, use:

benzatropine 1 to 2 mg orally, up to twice daily for up to 2 weeks; slowly reduce dose over the last few days to stop. cholinergic rebound syndrome benzatropine benzatropine benzatropine

If the above measures are ineffective, seek specialist advice.