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Author: Admin | 2025-04-28
Overall use of anticholinergic medications (3 years or more) across all groups of patients was linked with a 54% higher risk for developing dementia than taking the same dose for three months or less. Results also suggested that the risk for dementia with anticholinergics remain even after drug discontinuation.A case-control study published in 2019 in JAMA Internal Medicine also highlighted risk of dementia with long-term use of anticholinergics in persons 55 years or older.The population consisted of 58,769 patients with a diagnosis of dementia and 225,574 control patients.Utilizing prescription information for 56 drugs with strong anticholinergic properties, researchers analyzed total anticholinergic exposure by using the total standardized daily doses (TSDDs) of anticholinergic drugs prescribed during the 11 years prior to the diagnosis of dementia.Associations with dementia were significant for the anticholinergic antidepressants, antiparkinson agents, bladder antimuscarinics (for overactive bladder), and certain seizure medications.Lists of specific anticholinergic agents included as exposures can be viewed here.Anticholinergic drugs should not be used in conditions such as:benign prostatic hypertrophy (BPH)angle closure glaucomamyasthenia gravisAlzheimer’s diseasebowel blockageurinary tract blockage or urinary hesitancyDo not stop treatment without talking to your doctor. Patients and clinicians should avoid abruptly stopping long-term anticholinergic drugs, when possible, to minimize withdrawal symptoms. A slower taper may help to avoid side effects.The Beers CriteriaAs noted in the 2023 Beers Criteria, it is well established that many drugs with anticholinergic properties should be avoided in the elderly whenever possible.Drug Interactions with anticholinergics are common and pharmacists and physicians should screen for these drug interactions in patients who must use a drug with anticholinergic properties.It is also important to screen for and avoid combined use of two or more drugs that both have anticholinergic effects to minimize the risk for adverse drug effects.Taking opioids for pain and anticholinergics together can increase the risk of confusion, sedation, hallucination, serious constipation or fecal impaction.List of Anticholinergic Drugs to Be Avoided in the ElderlyMany of the below drugs are found in over-the-counter (OTC) products or in combination with other medications (prescription or OTC). For example, multiple OTC sleep medications contain diphenhydramine (Benadryl), a sedating antihistamine with strong anticholinergic properties. Always check with your pharmacist or doctor if you are concerned about the use of anticholinergic drugs.This is not a complete list of anticholinergic medications or the Beers Criteria, but includes many of the most common ones to avoid, when possible. Always check with your pharmacist or doctor if
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