Procyclidine

Procyclidine

Clinical data
AHFS/Drugs.com	Monograph
MedlinePlus	a605037
Routes of administration	By mouth, im, iv
ATC code	N04AA04 (WHO)
Pharmacokinetic data
Protein binding	~100%-albumin
Elimination half-life	~12 h
Identifiers
IUPAC name 1-cyclohexyl-1-phenyl-3-pyrrolidin-1-yl-propan-1-ol hydrochloride
CAS Number	77-37-2 77-37-2 (free base)
PubChem CID	207841
DrugBank	DB00387
ChemSpider	4750
UNII	C6QE1Q1TKR
ChEMBL	ChEMBL1761 Y
CompTox Dashboard (EPA)	DTXSID2023515
ECHA InfoCard	100.000.931
Chemical and physical data
Formula	C19H30ClNO
Molar mass	323.90 g·mol−1
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Procyclidine is an anticholinergic drug principally used for the treatment of drug-induced parkinsonism, akathisia and acute dystonia, Parkinson's disease, and idiopathic or secondary dystonia.

Uses

It is used in patients with parkinsonism and akathisia, and to reduce the side effects of antipsychotic treatment given for schizophrenia. Procyclidine is also a second-line drug for the treatment of Parkinson's disease. It improves tremor but not rigidity or bradykinesia.

Procyclidine is also sometimes used for the treatment of dystonia (but not tardive dyskinesia), a rare disorder that causes abnormal muscle contraction, resulting in twisting postures of limbs, trunk, or face.

Overdose

Signs of procyclidine overdose are those of an anticholinergic and include confusion, agitation and sleeplessness that can last up to or more than 24 hours. Pupils become dilated and unreactive to light. Tachycardia (fast heart beat), as well as auditory and visual hallucinations have also been reported.

Other known symptoms of overdose are: clumsiness or unsteadiness, being severely drowsy, having a severely dry mouth, nose, or throat, having an altered mood or other mental changes, seizures, being short of breath or having troubled breathing, a dry and warm, flushed skin.

A suspected overdose with severe life-threatening symptoms should immediately be brought to medical attention, where reversal can be attempted with physostigmine administered intravenously or subcutaneously.

Synthesis

Procyclidine synthesis:U.S. Patent 2,826,590

Procyclidine, 1-cyclohexyl-1-phenyl-3-pyrrolidinopropan-1-ol, is synthesized in exactly the same manner as was seen for trihexyphenidyl, except this time the linear synthesis begins with the preparation of 3-(1-pyrrolidino)propiophenone.

Procyclidine synthesis 2

In an interesting variation, the ketone is first reacted with phenylmagnesium bromide. Catalytic hydrogenation of the carbinol thus obtained can be stopped after the reduction of only one aromatic ring.

Side Effects

Side effects include nausea, constipation, urinary retention, blurred vision, anxiety, cognitive impairment, confusion, dizziness, gingivitis, hallucination, memory loss, rash and vomiting.

See also

• Biperiden
• Cycrimine

Further reading

• British National Formulary (45 ed.). March 2003.