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It is estimated that 45 million people suffer from schizophrenia around the world; it is among the top ten leading causes of disability. By 2050, this number will have grown to approximately 71 million people. Mental illnesses contribute more to the global burden of disease than all cancers combined. The present study has been planned to evaluate the effect of anticholinergic parkinol (benzhexol hydrochloride) and akineton (biperiden hydrochloride) on erythrocyte acetyl cholinesterase (AChE) activity and serum activities of gamma-glutamyl transferase (GGT), alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) in schizophrenic patients treated with haloperidol, and also to study the effect of the previously mentioned two anticholinergics on both the cognitive functions and psychiatric symptoms in such patients. The study was carried out on 30 male schizophrenic patients who were divided into two main groups (group 1 and group 2) each of 15 patients of comparable age. The present results revealed that the total score of (PANSS) showed a significant decrease in all studied groups. The total score of (MMSE) showed a significant increase in all studied groups. The AChE activity did not show any significant difference in all comparisons in all studied groups. In our study, there was a significant elevation of serum GGT, ALT, AST and ALP levels in some groups of treated patients as compared to pretreatment groups. The results obtained in our study showed a significant increase in serum GGT, ALT, AST, and ALP levels in groups treated with either (haloperidol+benzhexol hydrochloride) or (haloperidol+biperiden hydrochloride) as compared to the corresponding levels in groups treated with haloperidol only, respectively. From all results we can concluded that the biochemical parameters used in this study are useful in detecting any side effects of antipsychotic and anticholinergic drugs on liver functions. The treatment with (haloperidol+benzhexol hydrochloride) and (haloperidol+biperiden hydrochloride) are effective in decreasing the positive and negative symptoms of schizophrenia. INTRODUCTION Schizophrenia is a psychiatric diagnosis that describes a mental disorder characterized by impairments in the perception or expression of reality and by significant social or occupational dysfunction. A person experiencing schizophrenia is typically characterized as demonstrating disorganized thinking, and as experiencing delusions or auditory hallucinations(1). The report from the WHO on the diagnosis of schizophrenia according to the 779 Bull High Inst Public Health Vol.37 No. 3 [2007] International Classification of Diseases Revision Ten (ICD-10) stated that no strictly pathogenic symptoms can be identified, and it is useful to divide the various symptoms of schizophrenia into groups that have special importance for diagnosis and often occur together(2). It is estimated that 45 million people suffer from schizophrenia around the world(3); it is among the top ten leading causes of disability. No population is free of schizophrenia. By 2050, this number will have grown to approximately 71 million people(4). Mental illnesses contribute more to the global burden of disease than all cancers combined(5). The prevalence of schizophrenia is much greater in densely populated, large, urban areas of industrialized countries(6,7). There is a strong evidence that using certain drugs can trigger either the onset or relapse of schizophrenia in some people(8). Some of these drugs are amphetamines, hallucinogens, and cannabis(9). The antipsychotic drugs are a chemically diverse group of heterocyclic compounds, which ameliorate many symptoms of schizophrenia(10). The side effects of antipsychotic drugs have always been a major concern for clinicians and the appreciation of the importance in the treatment of schizophrenia has increased steadily over the years(11). Most conventional antipsychotic drugs have central nervous system effects, particularly extrapyramidal symptoms (EPS), hypotension, changes in liver function, antiadrenergic side effects, sexual dysfunction, and weight gain(12). The effect of conventional antipsychotic is presumed to be associated with dopamine D2-receptor blockade(13), that cause extrapyramidal side effects(14). One explanation of extrapyramidal disorders is an imbalance between dopaminergic and cholinergic systems in the brain(15). Antipsychotics (e.g., haloperidol) induced pseudo-parkinsonism that has the same clinical appearance as

The Biochemical, Cognitive, and Psychiatric Effects of Anticholinergics Benzhexol Hydrochloride and Biperiden Hydrochloride in Schizophrenic Patients