The Health Effects of Long-Term Use of Anticholinergics and Finding Better Alternatives


Anticholinergic medications are commonly prescribed to manage various conditions such as allergies, overactive bladder, and mental health disorders. While they can offer short-term relief, the long-term use of anticholinergics has raised concerns due to potential health effects and side effects. In this article, we’ll explore the risks associated with prolonged anticholinergic use and explore alternative strategies for managing these conditions more effectively.

The Impact of Long-Term Anticholinergic Use

Anticholinergics work by blocking the neurotransmitter acetylcholine, leading to relaxation of muscles and decreased secretions. However, chronic use of these medications can have several undesirable effects on health:
  • Cognitive Impairment: Prolonged anticholinergic use has been linked to cognitive decline, particularly in older adults. Memory loss, decreased attention span, and confusion are common cognitive side effects.
  • Increased Fall Risk: Anticholinergics can affect balance and coordination, increasing the risk of falls, fractures, and other injuries, especially in the elderly.
  • Gastrointestinal Issues: Long-term use can lead to gastrointestinal problems such as constipation, delayed gastric emptying, and decreased appetite.
  • Blurred Vision: Anticholinergics can cause blurred vision, light sensitivity, and difficulty focusing, impacting daily activities.
  • Urinary Retention: Anticholinergics can exacerbate urinary retention issues and increase the risk of urinary tract infections.
  • Dry Mouth and Skin: Anticholinergics can reduce saliva and sweat production, leading to dry mouth, throat, and skin.

Finding Alternatives

Fortunately, there are alternatives and strategies that can help manage conditions without relying solely on anticholinergic medications:
  1. Non-Medical Approaches: For allergies, consider allergen avoidance, nasal saline rinses, and air purifiers. Behavioral therapies and pelvic floor exercises can help manage overactive bladder.
  2. Medication Switch: Discuss switching to medications with fewer anticholinergic effects or exploring non-anticholinergic alternatives with your healthcare provider.
  3. Behavioral Therapy: Cognitive-behavioral therapy and relaxation techniques can help manage anxiety and certain mental health disorders without relying solely on medication.
  4. Natural Remedies: Explore natural alternatives like herbal supplements, acupuncture, or dietary changes to manage symptoms.
  5. Individualized Treatment Plans: Work with your healthcare provider to create a personalized treatment plan that considers your medical history, lifestyle, and preferences.


While anticholinergic medications can provide short-term relief for various conditions, their long-term use can have adverse health effects, particularly cognitive impairment and an increased risk of falls. As a proactive step, patients and healthcare providers should collaborate to explore alternative treatments and strategies to manage symptoms effectively while minimizing potential risks. Always consult a healthcare professional before making any changes to your treatment plan to ensure the best outcome for your health and well-being. Here is a list of common anticholinergic medications used for various medical conditions:
  1. . **Antihistamines:** – Diphenhydramine (Benadryl) – Chlorpheniramine (Chlor-Trimeton) – Loratadine (Claritin) – Cetirizine (Zyrtec) – Fexofenadine (Allegra)
  2. . **Antidepressants:** – Amitriptyline (Elavil) – Imipramine (Tofranil) – Doxepin (Silenor) – Nortriptyline (Pamelor)
  3.  **Antipsychotics:** – Chlorpromazine (Thorazine) – Haloperidol (Haldol) – Olanzapine (Zyprexa) – Quetiapine (Seroquel) – Risperidone (Risperdal)
  4. **Anti-Parkinson’s Medications:** – Benztropine (Cogentin) – Trihexyphenidyl (Artane)
  5. **Antispasmodics:** – Dicyclomine (Bentyl) – Hyoscyamine (Levsin)
  6. **Urinary Incontinence Medications:** – Oxybutynin (Ditropan) – Tolterodine (Detrol) – Solifenacin (Vesicare)
  7. **Motion Sickness Medications:** – Scopolamine (Transderm Scop)
  8. **Gastrointestinal Medications:** – Prochlorperazine (Compazine) – Metoclopramide (Reglan)
  9. **Sleep Aids:** – Doxylamine (Unisom)
  10. **Muscle Relaxants:** – Cyclobenzaprine (Flexeril)
  11. **Antiemetics:** – Promethazine (Phenergan)
  12. **Anticholinergic Eye Drops:** – Tropicamide (Mydriacyl) – Cyclopentolate (Cyclogyl)
It’s important to note that while these medications have anticholinergic properties, the extent of their effects can vary. Some medications on this list have stronger anticholinergic effects than others. Additionally, the impact of anticholinergics can be more pronounced in older adults and those with certain medical conditions. Always consult with a healthcare provider before starting or stopping any medication, especially if you have concerns about potential side effects.