What are anticholinergic drugs and is there a link to dementia?

The medications include antidepressants, bladder medications, antipsychotics and drugs used to treat Parkinson’s disease.

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Anticholinergic drugs work by blocking a natural chemical in the brain, acetylcholine.


An observational study released recently linked dementia in seniors with the usage of anticholinergic drugs. 

The study, published in the peer-reviewed JAMA Internal Medicine journal, said taking these kinds of drugs resulted in nearly “50 percent increased odds of dementia” in adults 55 and older. 

But just what are anticholinergic drugs, and what should adults do in response to the study? USA TODAY talked to Dr. Shelly Gray, director of the Plein Center for Geriatric Pharmacy Research at the University of Washington, to find out. 

What are anticholinergic drugs?

Gray said that anticholinergic drugs work by blocking a natural chemical in the brain, acetylcholine.

”Acetylcholine is a neurotransmitter that is important for memory and learning, but it is also important for other body functions such as heart rate and muscle contractions in the stomach,” she said.

She went on to explain that several different types of medications can be considered anticholinergics: 

  • Antidepressants such as amitriptyline, nortriptyline and paroxetine (Brand names: Elavil, Pamelor and Paxil)
  • Bladder medications such as oxybutynin, tolterodine (Brand names: Ditropan and Detrol)
  • Antipsychotics 
  • Drugs that are used for Parkinson’s disease

Are anticholinergic drugs harmful?

Scientists and doctors have known for quite some time that anticholinergics carry risks in seniors, according to Gray. 

“(Anticholinergic drugs) can cause a range of side effects such as constipation, difficulty with bladder control,” she said. “They can cause acute changes in cognition, meaning slight changes in cognition, and delirium. More recently, there is mounting evidence that they might be linked to dementia.”

The risk, according to the study, is only associated with 1,095 daily doses taken within a 10-year period, which is equivalent to taking a strong anticholinergic medication daily for at least three years.

What should I do if I’m taking anticholinergics?

Up to 35 percent of seniors living on their own — and more of those living in long-term care facilities — are currently taking anticholinergics, Gray said. 

Both Gray and the study warn people against stopping anticholinergics without consulting a doctor. 

Gray added that adults taking anticholinergics should discuss with a doctor whether the risks outweigh the benefits of continuing a medication.

While there are alternatives to anticholinergics, Gray cautioned that seniors should be wary that over-the-counter medications, such as sleep-aids or antihistamines, “do have strong anticholinergic effects.”

The study specifically examined adults 55 and older, she said, indicating that adults both midlife and older should be aware of the linkage. There is not adequate evidence on these kinds of medications effects on younger people. 

A full list of the medications can be found here.

Read more at usatoday.com.

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