Anticholinergic Drugs in Geriatric Psychopharmacology
Drugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits are limited by adverse effects which may be serious in particular circumstances. This review presents different aspects of the use of anticholinergics i...
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doaj-3c75d914badc4dcbb97b489f0da424bc2020-11-25T02:04:08ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2019-12-011310.3389/fnins.2019.01309490247Anticholinergic Drugs in Geriatric PsychopharmacologyJorge López-Álvarez0Jorge López-Álvarez1Julia Sevilla-Llewellyn-Jones2Julia Sevilla-Llewellyn-Jones3Luis Agüera-Ortiz4Luis Agüera-Ortiz5Luis Agüera-Ortiz6Luis Agüera-Ortiz7Servicio de Psiquiatría, Hospital 12 de Octubre (imas12), Madrid, SpainInstituto de Investigación, Hospital 12 de Octubre (imas12), Madrid, SpainInstituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, SpainInstituto de Investigación (IdISSC), Hospital Clínico San Carlos, Madrid, SpainServicio de Psiquiatría, Hospital 12 de Octubre (imas12), Madrid, SpainInstituto de Investigación, Hospital 12 de Octubre (imas12), Madrid, SpainCentro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, SpainDepartamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, SpainDrugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits are limited by adverse effects which may be serious in particular circumstances. This review presents different aspects of the use of anticholinergics in old age with a focus in psychogeriatric patients. We critically review published data on benefits and disadvantages of anticholinergics, which are often controversial. Prevalence, pathophysiology and measurement methods of the anticholinergic action of drugs are discussed. We also present the most important drawbacks resulting from its use, including effects on cognition in healthy and cognitively impaired people, in aged schizophrenia patients, emergence of delirium and psychiatric symptoms, influence in functionality, hospitalization, institutionalization and mortality, and the potential benefits and limitations of their discontinuation. Finally, we suggest practical recommendations for the safe use of anticholinergics in clinical conditions affecting elderly patients, such as dementia, schizophrenia and acute hallucinatory episodes, depression, anxiety, Parkinson’s disease, cardiovascular conditions and urinary incontinence.https://www.frontiersin.org/article/10.3389/fnins.2019.01309/fullanticholinergic drugselderlypotentially inappropriate prescriptionsadverse effectscognitiondementia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jorge López-Álvarez Jorge López-Álvarez Julia Sevilla-Llewellyn-Jones Julia Sevilla-Llewellyn-Jones Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz |
spellingShingle |
Jorge López-Álvarez Jorge López-Álvarez Julia Sevilla-Llewellyn-Jones Julia Sevilla-Llewellyn-Jones Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz Anticholinergic Drugs in Geriatric Psychopharmacology Frontiers in Neuroscience anticholinergic drugs elderly potentially inappropriate prescriptions adverse effects cognition dementia |
author_facet |
Jorge López-Álvarez Jorge López-Álvarez Julia Sevilla-Llewellyn-Jones Julia Sevilla-Llewellyn-Jones Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz Luis Agüera-Ortiz |
author_sort |
Jorge López-Álvarez |
title |
Anticholinergic Drugs in Geriatric Psychopharmacology |
title_short |
Anticholinergic Drugs in Geriatric Psychopharmacology |
title_full |
Anticholinergic Drugs in Geriatric Psychopharmacology |
title_fullStr |
Anticholinergic Drugs in Geriatric Psychopharmacology |
title_full_unstemmed |
Anticholinergic Drugs in Geriatric Psychopharmacology |
title_sort |
anticholinergic drugs in geriatric psychopharmacology |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neuroscience |
issn |
1662-453X |
publishDate |
2019-12-01 |
description |
Drugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits are limited by adverse effects which may be serious in particular circumstances. This review presents different aspects of the use of anticholinergics in old age with a focus in psychogeriatric patients. We critically review published data on benefits and disadvantages of anticholinergics, which are often controversial. Prevalence, pathophysiology and measurement methods of the anticholinergic action of drugs are discussed. We also present the most important drawbacks resulting from its use, including effects on cognition in healthy and cognitively impaired people, in aged schizophrenia patients, emergence of delirium and psychiatric symptoms, influence in functionality, hospitalization, institutionalization and mortality, and the potential benefits and limitations of their discontinuation. Finally, we suggest practical recommendations for the safe use of anticholinergics in clinical conditions affecting elderly patients, such as dementia, schizophrenia and acute hallucinatory episodes, depression, anxiety, Parkinson’s disease, cardiovascular conditions and urinary incontinence. |
topic |
anticholinergic drugs elderly potentially inappropriate prescriptions adverse effects cognition dementia |
url |
https://www.frontiersin.org/article/10.3389/fnins.2019.01309/full |
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