Neural Mechanisms of Anticholinergic Burden in Mid- to Late-Life Schizophrenia Spectrum
In this study, the investigators will examine whether a deprescription of unnecessary anticholinergic drugs (benztropine or trihexyphenidyl) can augment quality of life, functioning, and neurocognition in individuals who with schizophrenia. Individuals identified by clinical services who have unneeded prescriptions benztropine or trihexyphenidyl will be eligible for deprescription and study entry. Following a baseline evaluation and magnetic resonance imaging (MRI), participants will will be randomized to either staying on their anticholinergic drugs or undergoing deprescription per routine clinical care, and will undergo follow-up evaluations across 6 months. The investigators predict that reducing and deprescribing these drug, if clinically determined to be unnecessary will will enhance functioning, neurocognition
• Primary DSM-defined diagnosis of schizophrenia or schizoaffective disorder verified by the Structured Clinical Interview for DSM-5 (SCID).
• Prescription of benztropine or trihexyphenidyl for at least 6 months
• Age 40-70 years.
• ACBS score \>= 3.
• Mild or absent extrapyramidal symptoms (Determined by clinical pharmacists and prescribers).
• Competency and willingness to sign informed consent.
• Age 40-70 years.
• Competency and willingness to sign informed consent.