How do you treat extrapyramidal symptoms secondary to anti-psychotic use in patients who have not benefited from cogentin or benadryl?

In general, when addressing motor symptoms from antipsychotics (or any dopamine-blocking agents including dopamine-blocking antiemetics), I find it useful to break things down more specifically than just EPS. This often will determine the agent that will be most beneficial.

First Category: Hypokinet...

I use amantadine as a first line, as opposed to Cogentin or Benadryl for a PS. Cogentin is quite anticholinergic and often gives a “buzz". Benadryl is also considerably anticholinergic and fairly sedative.

I’m careful about anticholinergic effects, especially in the elderly. Also, evaluate whether a...

Does anyone use Artane anymore? I know that higher doses can cause psychosis and some like to abuse for a "buzz" but generally have found it helpful when benztropine isn't.

As mentioned, while I was working at Hillside, we stopped using anticholinergics in the late 80s and started using amantadine almost exclusively. It's nice, but less EPS medication would probably be the best today.