Anticholinergic medication side effects and risks

Drugs with anticholinergic effects range from over-the-counter antihistamines like Benadryl to prescription medications used to treat urinary incontinence (oxybutinin, sold as Ditropan) and antidepressant medications such as paroxetine (Paxil). These drugs can impair the function of the cholinergic system, which is essential for attention, concentration, and memory. Many doctors prescribe anticholinergic medications to their older patients,

Dr. Malaz Boustani of the Regenstrief Institute in Indianapolis, identified 27 studies in which researchers measured anticholinergic activity of medications that patients were taking and the effect on cognitive performance. All but two of the studies showed an association between use of anticholinergic medications and cognitive problems such as delirium soon after use, or mild cognitive impairment with continued use. Patients who develop delirium in the hospital spend more time in the hospital, have a greater likelihood of being transferred to a nursing home for care rather than being sent home, and have an increased risk of dying. There are drug and non-drug alternatives to practically all of the medications that have anticholinergic effects. Dr. Malaz Boustani believes there is enough evidence for the Food and Drug Administration to at least look into putting warning labels on over-the-counter medications and prescription drugs with anticholinergic effects. Journal of Clinical Interventions in Aging, online June 1, 2009

Anticholinergic medications and drugs
There are many anticholinergic medications and drugs
Cyclopentolate
Homatropine
Ipratropium
Propiverine - The muscarinic receptor antagonist propiverine used for therapy of overactive bladder undergoes first pass metabolism, leading to several active metabolites, which affect muscarinic receptors and L-type Ca(2+) channels with different potencies. M-5, the major metabolite in blood, and M-6 can be synthesized as cis- and trans-isomers.
Valethamate

Overactive urinary bladder control
Inhibitory effect of anticholinergics on the contraction of isolated caprine urinary bladder detrusor muscle.
Auton Autacoid Pharmacol. 2010 Jan 19. George N, Shiny PJ, Miriam J, Nancy CA, Dhanasekar KR, Peedicayil J. Department of Pharmacology, Christian Medical College, Vellore 632 002, India.
This study investigated whether four anticholinergics which are not clinically used for relaxing the urinary bladder detrusor muscle inhibit the contraction of isolated caprine (goat) detrusor muscle: cyclopentolate (100 nm), homatropine (5 mum), ipratropium (500 nm) and valethamate (1 mum). 2. The effects of these anticholinergics were compared with tolterodine (3 mum), an anticholinergic clinically used for relaxing the detrusor muscle. The inhibitory effect of each of these five anticholinergics was studied on six strips of caprine detrusor muscle made to contract with 100 mum acetylcholine (ACh) by determining the percent inhibition of height of contraction and the area under the contractile curve (AUC). 3. It was found that all five anticholinergics inhibited the ACh-induced contraction of the caprine detrusor and that this inhibition was reversed by raising the concentration of ACh. Hence, these four anticholinergics, like tolterodine, may be useful in managing clinical conditions that require relaxation of the detrusor muscle.

Can an anticholinergic medication be used together with chondroitin or msm supplements?
    Probably, since glucosamine, chondroitin and msm are safe supplements and don't have much cognitive effects.

choline pill side effects