Table of ContentsView AllTable of ContentsExamplesConditions TreatedDrug ActionSide EffectsWho Should Avoid Them?
Table of ContentsView All
View All
Table of Contents
Examples
Conditions Treated
Drug Action
Side Effects
Who Should Avoid Them?
Anticholinergicdrugs block the action of a chemical messenger calledacetylcholine. It plays a key role in involuntary movements needed for muscle and brain function. It transfers signals betweennervesand certain types of muscles and organs for normal brain and body function.
Anticholinergic drugs can improve many types of health problems, such asbladderproblems,depression, andParkinson’s disease. However, they can also cause a range of adverse effects, includingdry mouth,blurred vision, andmemory problems, most often in older adults.
This article includes names of anticholinergic drugs, what they treat, and their side effects. It also explains how these drugs work and who should not take them.
Grace Cary / Getty Images
Anticholinergic Drug Examples
More than 600 anticholinergic medications have anticholinergic effects. These substances include over-the-counter (OTC) medications, prescription drugs, and plants.
Some anticholinergic drugs are used for their anticholinergic effect. Other drugs are primarily used for other mechanisms of action but also have anticholinergic effects.
The following is a representation of some anticholinergic drugs. Some medications on this list may be marketed under additional brand names. A healthcare provider or pharmacist can inform you of the use and side effects.
Tricyclic antidepressants:
Antipsychotics:
Antiepileptics:
Parkinson’s disease medications:
Antidepressants:
Benzodiazepines:
Opioids:
Antihistamines:
Antispasmodics:
Antiulcer:
Bronchodilators:
Cardiovascular:
Corticosteroids:
Diuretics:
Urological:
What Is the Cholinergic System?Your cholinergic system is a branch of your autonomic nervous system. This system plays a key role in functions that include memory, digestion, heart rate, blood pressure, movement, and emotional processing.The autonomic nervous system includes the neurotransmitter acetylcholine, cholinergic receptors, choline acetyltransferase enzyme, and acetylcholinesterase enzyme. These molecules regulate your immune response and play a crucial role in maintaining internal equilibrium among your bodily systems.
What Is the Cholinergic System?
Your cholinergic system is a branch of your autonomic nervous system. This system plays a key role in functions that include memory, digestion, heart rate, blood pressure, movement, and emotional processing.The autonomic nervous system includes the neurotransmitter acetylcholine, cholinergic receptors, choline acetyltransferase enzyme, and acetylcholinesterase enzyme. These molecules regulate your immune response and play a crucial role in maintaining internal equilibrium among your bodily systems.
Your cholinergic system is a branch of your autonomic nervous system. This system plays a key role in functions that include memory, digestion, heart rate, blood pressure, movement, and emotional processing.
The autonomic nervous system includes the neurotransmitter acetylcholine, cholinergic receptors, choline acetyltransferase enzyme, and acetylcholinesterase enzyme. These molecules regulate your immune response and play a crucial role in maintaining internal equilibrium among your bodily systems.
Conditions Treated With Anticholinergics
Anticholinergic drugs treat a diverse range of medical conditions that include the following:
Psychiatric conditions:
Nonpsychiatric conditions:
Symptoms Treated
Anticholinergic drugs decrease or block the actions of acetylcholine. They can be effective in addressing the following symptoms:
What You Need to Know About the Nervous System
Anticholinergic Drug Action and Meaning
Anticholinergic drugs prevent acetylcholine from binding to muscarinic receptors. These receptors function in yourperipheralandcentral nervous systemsto handle involuntary muscle movements. This can be desirable in situations in which these systems produce unwanted effects due to disease.
By blocking acetylcholine, anticholinergic drugs can reduce involuntary muscle movements in areas such as your lungs, urinary tract, and gastrointestinal tract. They can also help manage symptoms related to cognitive function.
Anticholinergic Side Effects
Severe anticholinergic effects can occur based on the drug load (how much drug is active in the body) and individual vulnerability. Since there are so many anticholinergic drugs, severe effects can also develop if you take two or more different anticholinergic drugs.
These symptoms can indicate an anticholinergic overdose known as anticholinergic syndrome, toxicity, or poisoning. Severe anticholinergic effects can include the following:
Who Might Need to Avoid Anticholinergics (When Possible)
While anticholinergics can provide a range of benefits, they may not be the best choice for the following people. However, given the condition they are used to treat, the benefits of an anticholinergic medication may outweigh the risks for each group.
Older Adults
Your body’s production of acetylcholine slows with age, so using drugs that block its effects can further reduce acetylcholine levels to the point where they fail to support normal function.
Research indicates that long-term use of anticholinergics may contribute to a higher risk of cognitive decline and dementia in older adults. There is also a possible link between these drugs with falls, hospitalization, and mortality later in life.
Most drugs have a stronger effect on older people because the ability of the kidneys and liver to break down and clear drugs from your system slows with age. Hundreds of drugs in multiple drug classes have anticholinergic properties. Older people tend to take more medications for multiple conditions, putting them at risk of excessive anticholinergic effects.
Note that many people with Parkinson’s disease are older adults. A healthcare provider can determine if the benefits of Parkinson’s medications outweigh the risks.
People With Schizophrenia
Long-term use of anticholinergics is not advised for people with schizophrenia at any age. Over time, anticholinergics can increase cognitive impairment when used with antipsychotics (drugs used to treat schizophrenia), reducing quality of life. Research indicates that the use of anticholinergics in schizophrenia is linked with a reduction in the ability to perform cognitive tasks.
However, a healthcare provider can determine whether the benefits outweigh the risks in situations where, without these drugs, the person would need psychiatric hospitalization.
A Word From VerywellPolypharmacy is the simultaneous use of multiple medications for a single patient. It can lead to an increased risk of side effects and adverse events. Older adults are particularly at risk for issues stemming from polypharmacy.—KATHLEEN DALY, MD, MEDICAL REVIEW BOARD
A Word From Verywell
Polypharmacy is the simultaneous use of multiple medications for a single patient. It can lead to an increased risk of side effects and adverse events. Older adults are particularly at risk for issues stemming from polypharmacy.—KATHLEEN DALY, MD, MEDICAL REVIEW BOARD
Polypharmacy is the simultaneous use of multiple medications for a single patient. It can lead to an increased risk of side effects and adverse events. Older adults are particularly at risk for issues stemming from polypharmacy.
—KATHLEEN DALY, MD, MEDICAL REVIEW BOARD
Summary
Anticholinergic drugs are among the most commonly used treatments. They block the action of a neurotransmitter called acetylcholine. This chemical messenger transfers signals between cells that affect certain body functions.
Over 600 compounds can cause this effect. This can make it complex to treat older adults, who often need more than one drug to treat multiple health problems. The added effect can raise their risk of cognitive decline and dementia. People of all ages can have effects like dry mouth and blurred vision from these drugs.
Your healthcare provider can help you decide whether using these drugs is right for you. Factors such as your age, chronic conditions, and other drugs can affect your options.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kuebler K.Anticholinergics: Adverse effects.Am Nurse J. 2023;18(8):48-50. doi:10.51256/anj082348Grossi CM, Richardson K, Savva GM, et al.Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.BMC Geriatrics. 2020;20(1):267. doi:10.1186/s12877-020-01657-xLópez-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309LoVecchio F.Anticholinergics. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds.Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill Education; 2020.Ferreira-Vieira TH, Guimaraes IM, Silva FR, Ribeiro FM.Alzheimer’s disease: targeting the cholinergic system.Curr Neuropharmacol. 2016;14(1):101-115. doi:10.2174/1570159X13666150716165726National Library of Medicine.Anticholinergic agents.Harvard Health Publishing Harvard Medical School.Common anticholinergic drugs like Benadryl linked to increased dementia risk.Haddad C, Salameh P, Sacre H, Clément JP, Calvet B.Effects of antipsychotic and anticholinergic medications on cognition in chronic patients with schizophrenia.BMC Psychiatry. 2023;23(1):61. doi:10.1186/s12888-023-04552-y
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kuebler K.Anticholinergics: Adverse effects.Am Nurse J. 2023;18(8):48-50. doi:10.51256/anj082348Grossi CM, Richardson K, Savva GM, et al.Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.BMC Geriatrics. 2020;20(1):267. doi:10.1186/s12877-020-01657-xLópez-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309LoVecchio F.Anticholinergics. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds.Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill Education; 2020.Ferreira-Vieira TH, Guimaraes IM, Silva FR, Ribeiro FM.Alzheimer’s disease: targeting the cholinergic system.Curr Neuropharmacol. 2016;14(1):101-115. doi:10.2174/1570159X13666150716165726National Library of Medicine.Anticholinergic agents.Harvard Health Publishing Harvard Medical School.Common anticholinergic drugs like Benadryl linked to increased dementia risk.Haddad C, Salameh P, Sacre H, Clément JP, Calvet B.Effects of antipsychotic and anticholinergic medications on cognition in chronic patients with schizophrenia.BMC Psychiatry. 2023;23(1):61. doi:10.1186/s12888-023-04552-y
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kuebler K.Anticholinergics: Adverse effects.Am Nurse J. 2023;18(8):48-50. doi:10.51256/anj082348Grossi CM, Richardson K, Savva GM, et al.Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.BMC Geriatrics. 2020;20(1):267. doi:10.1186/s12877-020-01657-xLópez-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309LoVecchio F.Anticholinergics. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds.Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill Education; 2020.Ferreira-Vieira TH, Guimaraes IM, Silva FR, Ribeiro FM.Alzheimer’s disease: targeting the cholinergic system.Curr Neuropharmacol. 2016;14(1):101-115. doi:10.2174/1570159X13666150716165726National Library of Medicine.Anticholinergic agents.Harvard Health Publishing Harvard Medical School.Common anticholinergic drugs like Benadryl linked to increased dementia risk.Haddad C, Salameh P, Sacre H, Clément JP, Calvet B.Effects of antipsychotic and anticholinergic medications on cognition in chronic patients with schizophrenia.BMC Psychiatry. 2023;23(1):61. doi:10.1186/s12888-023-04552-y
Kuebler K.Anticholinergics: Adverse effects.Am Nurse J. 2023;18(8):48-50. doi:10.51256/anj082348
Grossi CM, Richardson K, Savva GM, et al.Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.BMC Geriatrics. 2020;20(1):267. doi:10.1186/s12877-020-01657-x
López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309
LoVecchio F.Anticholinergics. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds.Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill Education; 2020.
Ferreira-Vieira TH, Guimaraes IM, Silva FR, Ribeiro FM.Alzheimer’s disease: targeting the cholinergic system.Curr Neuropharmacol. 2016;14(1):101-115. doi:10.2174/1570159X13666150716165726
National Library of Medicine.Anticholinergic agents.
Harvard Health Publishing Harvard Medical School.Common anticholinergic drugs like Benadryl linked to increased dementia risk.
Haddad C, Salameh P, Sacre H, Clément JP, Calvet B.Effects of antipsychotic and anticholinergic medications on cognition in chronic patients with schizophrenia.BMC Psychiatry. 2023;23(1):61. doi:10.1186/s12888-023-04552-y
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