Each day, multiple people move forward in their daily lives with little or no understanding of the pros and cons of their anticholinergic meds. These drugs can be found in tablets used for sleep, allergy relief, bladder control, underlying depressive disorders, etc.
But as we age, it is critical to ask a rather straightforward question that most individuals do not consider: “Do I still need this medication”?
Let’s discuss the benefits of these medications, the risks associated with their use, and whether deprescribing is an appropriate consideration for you or your loved ones.
What Are Anticholinergic Medications?
Anticholinergic medications block a brain chemical called acetylcholine. This chemical helps with many body functions, like memory, digestion, and urination. When you take an anticholinergic drug, it stops acetylcholine from doing its job. This can help certain symptoms, but it can also cause problems.
Common Uses for Anticholinergic Drugs
These drugs are used for many conditions:
- Allergies
- Insomnia or trouble sleeping
- Motion sickness or nausea
- Depression
- Bladder problems
- Parkinson’s disease
- Asthma or COPD
You may have even taken them without knowing. Many over-the-counter products, like Benadryl or Tylenol PM, contain anticholinergic meds.
What’s on the Anticholinergic Medications List?
Anticholinergic Meds Can Be Hiding in Plain Sight
The anticholinergic medications list includes a wide range of drugs across many categories. Some are prescription-only, while others are sold over the counter. Below is a general list of anticholinergic drugs you might come across:
- Antihistamines: Diphenhydramine (Benadryl), chlorpheniramine, hydroxyzine
- Antidepressants: Amitriptyline, nortriptyline, paroxetine
- Antipsychotics: Quetiapine (Seroquel), olanzapine
- Bladder control meds: Oxybutynin, tolterodine, solifenacin
- Muscle relaxants: Cyclobenzaprine
- Sleep aids: Doxylamine, Tylenol PM
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Knowing which drugs have anticholinergic effects is the first step toward smarter choices. If you recognize any of these in your medicine cabinet, it’s worth discussing them with your healthcare provider.
Why Should You Care About Anticholinergic Side Effects?
As helpful as these drugs can be, they also carry risks, especially for older adults. Anticholinergic side effects can include:
- Dry mouth
- Constipation
- Trouble urinating
- Blurry vision
- Drowsiness or confusion
- Memory loss
- Dizziness or falls
- Hallucinations in severe cases
The longer you use these drugs, the higher your risk. Taking more than one drug with anticholinergic effects also increases the chance of side effects.
Seniors Are at Higher Risk
Older adults process medications differently. As we age, the liver and kidneys slow down, making it harder to break down drugs. The brain also becomes more sensitive. This means that anticholinergic meds can build up and cause problems faster.
Studies have even linked long-term use of anticholinergic medications to a higher risk of dementia. While this hasn’t been proven, it’s a serious concern.
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What Is Deprescribing?
Deprescribing means slowly stopping a medication that might no longer be needed. It doesn’t mean quitting cold turkey. Instead, it’s a careful process done with your doctor, pharmacist, or nurse.
Deprescribing anticholinergic drugs can help reduce side effects, improve memory and thinking, and lower the risk of falls or hospital visits.
When Should You Ask About Deprescribing?
You should talk to your healthcare provider if:
- You feel groggy, confused, or off-balance.
- You take many medications.
- You’re over 65.
- You’ve had a fall or near-fall.
- You’re starting to forget things more often.
These could be signs that your anticholinergic meds are doing more harm than good.
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How to Start the Conversation
Use these tips when talking to your doctor or pharmacist:
- Ask: “Is this drug still necessary?”
- Show them a full list of everything you take, even over-the-counter meds.
- Ask about safer alternatives.
- Use tools like the Anticholinergic Burden Calculator (acbcalc.com) to understand your total medication risk.
What Are Safer Options?
In some cases, you can switch to a drug with fewer anticholinergic effects or none at all. For example:
- Instead of diphenhydramine for sleep, try melatonin.
- Instead of oxybutynin for the bladder, ask about newer, safer options.
- For allergies, loratadine (Claritin) is often a better choice.
Know the Signs of Anticholinergic Toxicity
If you or someone you care for takes too many anticholinergic meds, the body can react badly. Watch out for:
- Confusion
- Rapid heartbeat
- Dry, hot skin
- Hallucinations
- Trouble breathing
- Seizures
These are signs of anticholinergic toxicity, a medical emergency. Call 911 or go to the ER right away.
Stay Cool and Hydrated
Anticholinergic drugs can reduce sweating, raising your risk of heat stroke. Be careful during hot weather or exercise. Drink plenty of water and avoid overheating.
Conditions That May Worsen With Anticholinergics
These medications may not be safe if you have certain health issues. Tell your doctor if you have:
- Glaucoma
- Enlarged prostate
- High blood pressure
- Heart problems
- Liver or kidney disease
- Parkinson’s or dementia
- Myasthenia gravis
These conditions can make anticholinergic drugs to effects even worse.
Should You Still Be Taking Anticholinergic Meds?
The answer depends on your current health, age, and what you’re taking them for. But one thing is clear: it’s smart to review your meds regularly.
Many people find they no longer need some anticholinergic medications. Others discover there are safer choices. Talk to your healthcare provider. Ask the right questions. And don’t be afraid to bring up deprescribing.
Quick Recap:
- Anticholinergic meds help with many problems, but can cause serious side effects.
- Older adults are at higher risk.
- Deprescribing means stopping drugs that may no longer be needed.
- Talk to your doctor about safer options.
- Use the anticholinergic drugs list to check your meds.
Your health is always worth a second look. And when it comes to anticholinergic medications, less may truly be more.
Take Action Now
- Make a list of everything you take, including vitamins and OTC meds.
- Look up each drug to see if it has anticholinergic properties.
- Use the Anticholinergic Burden Calculator.
- Schedule a review with your pharmacist or doctor.
Reducing your anticholinergic burden could mean fewer falls, better memory, and a healthier life. Always make changes with medical support; never stop a medication on your own.