Anti-psychotics are the mainstay of treatment for Schizophrenia and psychotic disorders. Historically, anticholinergics have been prescribed to prevent or treat extrapyramidal side effects (EPS) associated with first-generation antipsychotics (FGAs). Even though newer antipsychotics are associated with markedly lower rates of EPS, concurrent anticholinergic use remains high. Use of these medications has potential for long-term side effects, worsening of EPS and poor adherence. We have briefly discussed the limited association between second-generation antipsychotics (SGAs) and EPS, the efficacy of anticholinergics for different types of EPS, and summarized various national and international guidelines on the subject. In conclusion, there is no evidence for prophylactic use of anticholinergics with antipsychotics. Clinicians need to guard against this tendency to be unduly cautious.
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http://dx.doi.org/10.4103/ipj.ipj_269_21 | DOI Listing |
BMC Geriatr
January 2025
Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, 576104, India.
Introduction: Mental disorders are prevalent among older adults, often leading to the use of multiple medications, many with anticholinergic properties. Polypharmacy, common in this population, is a major contributor to anticholinergic burden, which is linked to cognitive and physical decline. This study investigates the relationship between polypharmacy and anticholinergic burden across seven anticholinergic burden scales in elderly patients attending the psychiatric outpatient.
View Article and Find Full Text PDFClin Psychopharmacol Neurosci
February 2025
Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA.
Schizophrenia is a chronic and severe mental illness associated with substantial morbidity and mortality. Antipsychotics primarily rely on direct dopamine blockade, leading to potential life-interfering adverse events. The purpose of this review is to describe the safety and efficacy of xanomeline-trospium (Cobenfy), a Food and Drug Administration approved treatment for schizophrenia in adults.
View Article and Find Full Text PDFLangmuir
January 2025
Department of Chemistry, School of Applied Sciences, REVA University, Bengaluru 560064, Karnataka, India.
Promethazine hydrochloride (PMHC) is a vital drug that is used as an anticholinergic, antipsychotic, antihistaminic, analgesic, sedative, and neuroleptic. However, the overdosage of PMHC also causes reproductive variations, cardiac changes, hypotension, and endocrinal variations. Hence, the detection of PMHC is crucial.
View Article and Find Full Text PDFPharmaceuticals (Basel)
November 2024
Department of Orthopaedics, Trauma and Reconstructive Surgery, Division of Geriatric Traumatology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.
Background/objectives: Falls and fractures are emerging as a near-pandemic and major global health concern, placing an enormous burden on ageing patients and public health economies. Despite the high risk of polypharmacy in the elderly patients, falls are usually attributed to age-related changes. For the "Individual Pharmacotherapy Management (IPM)" established at the University Hospital Halle, the IPM medication adjustments and their association with in-hospital fall prevention were analysed.
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