The abuse and overdose of anti-cholinergic agents such as benztropine
is well reported in the psychiatric and emergency medicine journals. H
owever, despite almost 40 years since the first modern report, physici
ans in general remain poorly aware of anti-cholinergic abuse. A case r
eport of recreational overdose of benztropine in a 19 year old schizop
hrenic patient is presented. Delirium and anti-cholinergic manifestati
ons persisted for five days necessitating prolonged hospitalization. T
he literature on benztropine abuse and overdose is reviewed.