How are anticholinergic medications used for schizophrenia?

Anticholinergics block the action of the neurotransmitter acetylcholine. Anticholinergic medications may have some utility for the treatment of side effects of antipsychotic medications, including movement disorders like akathisia (a type of restlessness, a common side effect of many neuroleptics), as well as excessive salivation. Adjunct medications prescribed to treat such side effects may contribute to increasing adherence to antipsychotic medications, and reduce the risk of psychotic relapse.

What is the evidence for anticholinergic medications?

Moderate quality evidence suggests small to medium-sized effects of greater improvement in hypersalivation with astemizole or propantheline over placebo, and no differences in adverse effects. There is moderate to low quality evidence for greater improvement in hypersalivation with propantheline over astemizole, with no differences in adverse effects.

Moderate to low quality evidence finds a significant benefit of isocarboxazid (MAO inhibitor) over the anticholinergic procyclidine for tardive dyskinesia.

September 2020

Last updated at: 4:57 am, 21st September 2020
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