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Pharmacological phenomena

Review collates evidence on increased risk of death for anticholinergics

Drugs with anticholinergic effects have adverse effects affecting both central and peripheral nervous systems. These adverse effects may include cognitive impairment, falls and all-cause mortality. In the image, an elderly person holds a walking stick

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A new systematic review and meta-analysis suggests that patients using any drug with anticholinergic effects have a 45% increased risk of cognitive impairment

Drugs with anticholinergic effects have adverse effects affecting both central and peripheral nervous systems because of the wide distribution of muscarinic acetylcholine receptors in the body. These adverse effects may include cognitive impairment, falls and all-cause mortality, according to a systematic review and meta-analysis published in the British Journal of Clinical Pharmacology[1].

The analysis included 18 studies with a total of 124,286 participants. Use of any drug with anticholinergic effects was associated with a 45% increased risk of cognitive impairment while each 1-unit increase in the anticholinergic cognitive burden scale was associated with a doubling in the odds of all-cause mortality. Also, exposure to olanzapine or trazodone was associated with an increased risk of falls.

“Our findings raise concerns about the risks of prescribing of drugs with anticholinergic effects,” say the authors.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20068681

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  • A new systematic review and meta-analysis suggests that patients using any drug with anticholinergic effects have a 45% increased risk of cognitive impairment

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