Anticholinergics: List, Side Effects, Uses, Warnings, and More

Anticholinergics are drugs that block the action of acetylcholine. Acetylcholine is a neurotransmitter, or a chemical messenger. It transfers signals between certain cells to affect how your body functions.

Anticholinergics can treat a variety of conditions, including urinary incontinence, overactive bladder (OAB), chronic obstructive pulmonary disorder (COPD), and certain types of poisoning. They also help block involuntary muscle movements associated with certain diseases such as Parkinson's disease. Sometimes, they're used before surgery to help maintain body functions while a person is treated with anesthesia.

Read on for a list of anticholinergic drugs, information about how they work, and what you should know about their risks and side effects.

Anticholinergics are only available with a doctor's prescription. Examples of these drugs include:

• atropine (Atropen)
• belladonna alkaloids
• benztropine mesylate (Cogentin)
• clidinium
• cyclopentolate (Cyclogyl)
• darifenacin (Enablex)
• dicylomine
• fesoterodine (Toviaz)
• flavoxate (Urispas)
• glycopyrrolate
• homatropine hydrobromide
• hyoscyamine (Levsinex)
• ipratropium (Atrovent)
• orphenadrine
• oxybutynin (Ditropan XL)
• propantheline (Pro-banthine)
• scopolamine
• methscopolamine
• solifenacin (VESIcare)
• tiotropium (Spiriva)
• tolterodine (Detrol)
• trihexyphenidyl
• trospium

Each of these drugs works to treat specific conditions. Your doctor will choose the best drug for your condition.

Did you know?Some anticholinergics are derived from plants of the deadly nightshade family called Solanaceae. Burning the roots, stems, and seeds of these plants releases the anticholinergics. Inhalation of the smoke has been used for hundreds of years to treat obstructive airway disease.

Anticholinergics block acetylcholine from binding to its receptors on certain nerve cells. They inhibit actions called parasympathetic nerve impulses.

These nerve impulses are responsible for involuntary muscle movements in the gastrointestinal tract, lungs, urinary tract, and other parts of your body. The nerve impulses help control functions such as salivation, digestion, urination, and mucus secretion.

Blocking acetylcholine signals can decrease involuntary muscle movement, digestion, and mucus secretion. That's why these drugs can cause certain side effects, such as retaining urine and having a dry mouth.

Anticholinergics are used to treat a variety of conditions. These include:

• chronic obstructive pulmonary disease (COPD)
• overactive bladder and incontinence
• gastrointestinal disorders, such as diarrhea
• asthma
• dizziness and motion sickness
• poisoning caused by toxins such as organophosphates or muscarine, which may be found in some insecticides and poisonous mushrooms
• symptoms of Parkinson's disease, such as abnormal involuntary muscle movement

Anticholinergics can also be used as muscle relaxants during surgery to assist with anesthesia. They help keep the heartbeat normal, relax the patient, and decrease saliva secretions.

Some doctors prescribe anticholinergics for off-label use to help decrease excessive sweating. The anticholinergics used most for this treatment are glycopyrrolate cream and oxybutynin oral tablets.

As do many drugs, anticholinergics come with several warnings.

Heat exhaustion and heat stroke

Anticholinergics decrease how much you sweat, which can cause your body temperature to rise. Be extra careful not to become overheated during exercise, hot baths, or hot weather while taking one of these drugs. Decreased sweating can put you at risk of heat stroke.

Overdose and alcohol

Using too much of an anticholinergic drug can result in unconsciousness or even death. These effects can also happen if you take anticholinergics with alcohol. Signs of an overdose include:

• dizziness
• severe drowsiness
• fever
• severe hallucinations
• confusion
• trouble breathing
• clumsiness and slurred speech
• fast heartbeat
• flushing and warmth of the skin

If you think you or someone you know has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Conflicting conditions

Anticholinergics can be used to treat many conditions, but they aren't for everyone. For example, these drugs aren't usually prescribed for older people. Anticholinergics are known to cause confusion, memory loss, and worsening mental function in people who are older than 65 years. In fact, recent studies have linked use of anticholinergics with increased risk of dementia.

Also, people with the following conditions shouldn't use anticholinergics:

• myasthenia gravis
• hyperthyroidism
• glaucoma
• enlarged prostate
• hypertension (high blood pressure)
• urinary tract blockage
• increased heart rate (tachycardia)
• heart failure
• severe dry mouth
• hiatal hernia
• severe constipation
• liver disease
• Down syndrome

Tell your doctor if you have any of these conditions. Also, tell your doctor if you have a history of allergies to anticholinergics.

Avoiding use in older adultsThe American Geriatrics Society strongly recommends avoiding the use of anticholinergic medications in older adults. This is because seniors may be more likely to experience unwanted side effects than younger people.

Even when using this drug properly, side effects can happen. The possible side effects of anticholinergics depend on the specific drug and dosage you take.

Side effects can include:

• dry mouth
• blurry vision
• constipation
• drowsiness
• sedation
• hallucinations
• memory problems
• trouble urinating
• confusion
• delirium
• decreased sweating
• decreased saliva

Dementia warningLong-term use of anticholinergics, as well as use of these drugs in older people, has been linked with an increased risk of dementia. If you've been prescribed one of these drugs and have concerns about this risk, be sure to talk to your doctor.

Anticholinergics can be used to treat a variety of conditions. If you think one of these drugs could help you, talk to your doctor. Your doctor can determine if treatment with an anticholinergic would be a good option for you. They can also answer any questions you have about risks, side effects, and what to expect with treatment.

Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions. These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder.