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Schizophrenia is associated with cognitive deficit either due to the disease itself or from the side effects of medication. Cognition mainly the executive function is under the jurisdiction of prefrontal cortex via the influence of both dopamine and acetylcholine neurotransmitters (1,2). Antipsychotics are the notorious cause of cognitive deficit via two mechanisms which are D4 and/or cholinergic receptors blockade. Antipsychotics dosage was negatively correlated with the cognition particularly on the declarative memory (3). A study showed that the cognition of schizophrenia patient is generally impaired with the increment of the antipsychotics dosage with or without anticholinergic property. But, those treated with antipsychotics that possess anticholinergic property fare even worse (4) . However, anticholinergic delirium associated with flupenthixol and benzhexol within therapeutic dosages have never been reported. Thereby, it is crucial to be vigilant of this serious adverse effect to accurately identify and manage the condition appropriately. Case Report

Anticholinergic Delirium Superimposed On Severe Cognitive Deficit Secondary to Benzhexol and Flupenthixol Decanoate: A Dilemma In Management.