Current use of anticholinergic medications in a large naturalistic sample of psychiatric patients

• Published in: Journal of Neural Transmission 2021-02, Vol.128 (2), p.263-272
• Main Authors: Toto, Sermin, Hefner, Gudrun, Hahn, Martina, Hiemke, Christoph, Roll, Sibylle C., Wolff, Jan, Klimke, Ansgar
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Neurology; Neurosciences; Psychiatry; Psychiatry and Preclinical Psychiatric Studies - Original Article
• ISSN: 0300-9564; 1435-1463
• DOI: 10.1007/s00702-020-02298-5

Due to the high number of psychotropic drugs with anticholinergic potential, patients taking psychotropic drugs are at high risk for anticholinergic adverse drug reactions (ADRs). The aim of this study was to analyze the prevalence and type of pharmacodynamic anticholinergic drug–drug interactions in psychiatric patients. The retrospective longitudinal analysis used data from a large pharmacovigilance study conducted in ten German psychiatric hospitals. Anticholinergic burden of drugs was defined as “strong” or “moderate” based on current literature. Number and type of anticholinergic drugs were assessed. In total, 27,396 patient cases (45.6% female) with a mean age of 47.3 ± 18.3 years were included. 17.4% ( n  = 4760) of patients were ≥ 64 years. 35.4% of the patients received between one and four anticholinergic drugs simultaneously. A combination of drugs with anticholinergic potential was detected in 1738 cases (6.3%). Most prescribed drugs were promethazine ( n  = 2996), olanzapine ( n  = 2561), biperiden ( n  = 1074), and doxepin ( n  = 963). Patients receiving anticholinergic combinations were younger (45.7 vs. 47.4 years, p