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Dear Hilary- Cogentin is in a class of drugs called anticholinergics. Anticholinergics were the first class of drugs used to treat Parkinsonian symptoms. Parkinson's is a neurological degenerative condition affecting the dopaminergic neurons. What we know with Parkinson's is that there is an imbalance between two neurotransmitters, dopamine and acetylcholine. As a result, there is a decrease level of dopamine and we tend to see a higher level of acetylcholine. Cogentin works by decreasing the level of acetylcholine; thereby, creating a balance between dopamine and acetylcholine and hopefully alleviating Parkinsonian symptoms. As a pharmacist for Athena Rx Home Pharmacy, we tend not to see anticholinergics used as frequently due to the newer class of medications available to treat Parkinsonian symptoms. We also tend not to see them used in patients over the age of 65 due to the risk of confusion, dryness of mouth, blurred vision, dizziness, constipation, and dryness of the eyes. All side effects associated with anticholinergics. The newer class of agents available today include the dopamine agonists. These include Permax, Parlodel, Requip, and Mirapex. These agents work by "imitating" dopamine. They act directly on the dopamine receptors and help to alleviate Parkinsonian symptoms. One common side effect of these agents includes drowsiness. However, many Parkinsonians and physicians favor Permax because it doesn't appear to cause as much drowsiness. Dopamine agonists are sometimes prescribed alone, but most often prescribed in conjunction with levodopa/carbidopa. When prescribed in conjunction with levodopa/carbidopa the daily dose of levodopa/carbidopa can usually be decreased. Dopamine agonists are especially helpful when levodopa/carbidopa begins to lose its effectiveness. I welcome the opportunity to answer additional questions for you. If you have any questions, please feel free to contact me at 1-800-537-8899 ext. 6104. Sincerely, Dominic Marchese, RPh. Athena Rx Home Pharmacy Pharmacy Service Specialist 1-800-5-ATHENA