Anticholinergics are drugs that block the action of acetylcholine. Acetylcholine is a neurotransmitter, or a chemical messenger. It transfers signals between certain cells to affect how your body functions.
Anticholinergics can treat a variety of conditions, including urinary incontinence, chronic obstructive pulmonary disorder, and certain types of poisoning. They also help block involuntary muscle movements associated with certain diseases. Sometimes, they’re used before surgery to help maintain body functions during anesthesia.
Here's a list of anticholinergic drugs, plus what you need to know about how they work.
Anticholinergics are only available with a doctor’s prescription. Examples of these drugs include:
- trihexyphenidyl (Artane)
- benztropine mesylate (Cogentin)
- ipratropium (Atrovent)
- tiotropium (Spiriva)
- orphenadrine (Norflex)
- flavoxate (Urispas)
- oxybutynin (Ditropan, Oxytrol)
- hyoscyamine (Levsinex)
- tolterodine (Detrol)
- belladonna alkaloids
- fesoterodine (Toviaz)
- solifenacin (Vesicare)
- darifenacin (Enablex)
- propantheline (Pro-banthine)
Each of these drugs works to treat specific conditions. A doctor will choose the best drug for your condition.
How they work
Anticholinergics block acetylcholine from binding to its receptors on certain nerve cells. They inhibit parasympathetic nerve impulses. These nerve impulses are responsible for involuntarily muscle movements in the gastrointestinal tract, lungs, urinary tract, and other parts of your body. The nerve impulses help control functions such as salivation, digestion, urination, and mucus secretion.
Blocking acetylcholine signals can decrease involuntary movement, digestion, and mucus secretion. If you take an anticholinergic, you may retain urine and experience dry mouth.
Anticholinergics are used to treat a variety of conditions. These include:
- gastrointestinal disorders, such as diarrhea, overactive bladder, and incontinence
- chronic obstructive pulmonary disease (COPD)
- dizziness and motion sickness
- poisoning caused by toxins such as organophosphates or muscarine, which may be found in some insecticides and poisonous mushrooms
- symptoms of Parkinson’s disease, such as abnormal involuntary muscle movement
Anticholinergics can also be used as muscle relaxants during surgery to assist with anesthesia. They help keep the heartbeat normal, relax the patient, and decrease saliva secretions.
Some doctors have prescribed anticholinergics in an off-label use to help decrease excessive sweating. The anticholinergics used most for this treatment are glycopyrrolate cream and oxybutynin oral tablets.
Heat exhaustion and heat stroke
Anticholinergics decrease how much you sweat, which can cause your body temperature to increase. Be extra careful not to become overheated during exercise, hot baths, or hot weather. Decreased sweating can put you at risk of heat stroke.
Overdose and alcohol
Using too much of an anticholinergic drug can result in unconsciousness or even death. These effects can also happen if you take anticholinergics with alcohol. Get emergency help immediately if you or someone you know may have taken too much of these drugs. Signs of an overdose include:
- severe drowsiness
- severe hallucinations
- trouble breathing
- clumsiness and slurred speech
- fast heartbeat
- flushing and warmth of the skin
Anticholinergics can be used to treat many conditions, but they aren’t for everyone. For example, these drugs aren’t usually prescribed to older people. Anticholinergics are known to cause confusion, memory loss, and worsening mental function in people who are older than 65 years.
Also, people with the following conditions shouldn’t use anticholinergics:
- myasthenia gravis
- enlarged prostate
- hypertension (high blood pressure)
- urinary tract blockage
- increased heart rate (tachycardia)
- heart failure
- severe dry mouth
- hiatal hernia
- severe constipation
- liver disease
- Down syndrome
Tell your doctor if you have any of these conditions. Also, tell your doctor if you have a history of allergies to anticholinergics.
Even when using this drug properly, side effects can happen. The possible side effects of anticholinergics depend on the specific drug and dosage you take. You may or may not experience any side effects at all.
Side effects may include:
Anticholinergics are helpful to many people for a variety of conditions. Talk to your doctor if you think one of these drugs could help you. Your doctor can determine if one of these drugs is best, and they can answer any other questions you have about side effects and what to expect.