What are anticholinergic medications?
Some medications work by blocking a chemical in your body called acetylcholine so they are referred to as anticholinergic. Acetylcholine is used in many parts of your body and helps you stay alert, keep a steady heart rate, breathe, digest food, sweat and empty your bladder. When you take an anticholinergic medication, it acts on many parts of your body at the same time.
Anticholinergic medicines can be prescribed as:
• Bladder control medications e.g. oxybutynin, tolterodine, solifenacin, trospium
• Allergy medications e.g. chlorphenamine (Piriton), hydroxyzine
• Antidepressants e.g. paroxetine, amitriptyline
• Medication for nerve pain e.g. amitriptyline, nortriptyline
• Non-prescription sleeping tablets e.g. diphenhydramine (Nytol, Sleepeaze, NightAid), promethazine, (Phenergan, Sominex, Night Nurse).
Are there any side effects or risks?
You can get side effects when you take anticholinergic medicine, and some factors increase your risk of experiencing them. These include:
• You are taking higher doses
• You take the medicine for a long time
• You are taking more than one anticholinergic medication
• You are older.
As we get older, our liver and kidneys aren’t able to process medications as well, so we become more sensitive to them. Also, many older adults have more than one health condition and may take many medications, including one or more anticholinergics. The more medications a person takes, the more likely it is that he or she will have unwanted side effects. Have a look here for more information about reducing harm from medication.
Diagram from: https://bswtogether.org.uk/medicines/wp-content/uploads/sites/3/2022/12/Anticholinergic-Medications-Leaflet-DIGITAL-2022-1.pdf
Do anti-cholinergic medications increase the risk of dementia?
In the last few years studies have suggested that older adults who use anticholinergic medications for a long time, or at higher doses, may have a higher risk of dementia. Research has not proven that anticholinergic drugs cause dementia, but it does suggest that older adults should limit the number of anticholinergic medications they take and use the lowest dose for the shortest length of time.