Diphenylacetonitrile (I) was alkylated with 1,3-dibromopropane (II) in the presence of NaH in DMF to afford the bromopropyl derivative (III). Subsequent condensation of bromide (III) with 4-(4-chlorophenyl)-4-hydroxypiperidine (IV) gave the tertiary amine (V). This was then quaternized with methyl iodide to furnish the corresponding piperidinium salt.

Alkylation of diphenylacetonitrile (I) with 1,3-dibromopropane (II) in the presence of NaH in DMF affords 5-bromo-2,2-diphenylvaleronitrile (III). This is then condensed with 4-(4-chlorophenyl)-4-hydroxypiperidine (IV) to produce the title compound.