Which anticholinergic drug is used as an adjunct in the treatment of Parkinson's disease to correct the imbalance between dopamine and acetylcholine?
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Correct answer: Benztropine
In Parkinson's disease, the loss of dopaminergic neurons leads to a relative overactivity of cholinergic neurons in the striatum. Benztropine is a tertiary amine that crosses the blood-brain barrier and restores this balance, reducing tremor and rigidity. Quaternary agents such as ipratropium and glycopyrrolate, and the bladder-selective tolterodine, act peripherally and have no useful central effect.
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