Depression A List of Anticholinergics A group of prescription medications that block acetylcholine By Kristen Fuller, MD Kristen Fuller is a physician, a successful clinical mental health writer, and author. She specializes in addiction, substance abuse, and eating disorders. Learn about our editorial process Kristen Fuller, MD Medically reviewed by Medically reviewed by Daniel B. Block, MD on March 02, 2021 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Review Board Daniel B. Block, MD on March 02, 2021 Print FatCamera / Getty Images Table of Contents View All Table of Contents What Anticholinergics Are Used For List of Anticholinergics Side Effects of Anticholinergics Anticholinergics are a group of prescription medications that block acetylcholine, a brain hormone (neurotransmitter) that plays a vital role in smooth, cardiac, and skeletal muscle contractions as well as mental functions such as memory, REM sleep, attention, learning, and cognition. Anticholinergics block acetylcholine at the receptors, but because they block a wide variety of receptors in the brain, this class of medication can also elicit many different side effects. Anticholinergics help with slowing the gut down, thereby causing relief from diarrhea. They also allow the bladder to relax, thereby helping with urinary incontinence. What Anticholinergics Are Used For Anticholinergics are used to treat various medical conditions including: Chronic obstructive pulmonary disorder (COPD) Overactive bladder Urinary incontinence Gastrointestinal disorders, including diarrhea and irritable bowel syndrome Poisoning due to toxic mushrooms and insecticides Symptoms of Parkinson’s disease, such as abnormal involuntary muscle movement Asthma Eye inflammation/eye examinations that dilate the pupil Dizziness Motion sickness Tips for Coping With Nausea While on Antidepressants List of Anticholinergics Atropine: Used to treat organophosphate or nerve gas poisoning Belladonna alkaloids: Combination of acetycholine and phenobarbital used to relieve stomach cramping associated with irritable bowel syndrome and spastic colon Benztropine mesylate: Used to treat symptoms of Parkinson’s disease as well as extrapyramidal side effects from anti-psychotics Clidinium: Combined with the benzodiazepine chlordiazepoxide to help treat stomach ulcers and irritable bowel syndrome Cyclopentolate: Used in eyed examinations to dilate the pupil Darifenacin: Relaxes the muscles in the bladder to treat overactive bladders Dicylomine: Works by slowing the natural movements in the gut to help relive irritable bowel syndrome Fesoterodine: Used to treat symptoms of an overactive bladder Flavoxate: Used to treat bladder symptoms such as frequent urination, urgent urination, increased nighttime urination, bladder pain, and leakage Glycopyrrolate: Helps to control conditions that involve excessive stomach acid production such as peptic ulcer disease. The injectable form of glycopyrrolate is also used to reduce saliva, nasal, lung, and stomach secretions and to help control heart rate during surgery. Homatropine hydrobromide: Works by dilating the pupil of the eye to treat inflammatory conditions such as uveitis Hyoscyamine: Works by reducing stomach acid production, slowing down the natural movements of the gut, and relaxing muscles in the stomach, gallbladder, kidneys, and intestines. It also reduces the production of certain body fluids such as saliva and sweat. Ipratropium: Works by relaxing and opening the air passages (bronchodilates) and is used to prevent wheezing, shortness of breath, coughing, and chest tightness in individuals with chronic obstructive pulmonary disease (COPD). Orphenadrine: Relaxes skeletal muscles to help relieve muscle spasms and pain Oxybutynin: Relaxes the bladder and used to treat symptoms of overactive bladder Propantheline: Used for the treatment of excessive sweating (hyperhidrosis), cramps or spasms of the stomach, intestines, or bladder, and involuntary urination Scopolamine: Used to treat motion sickness and postoperative nausea and vomiting. Solifenacin: Used to treat neurogenic detrusor overactivity (a bladder control condition caused by the brain, spinal cord, or nerve problem) Tiotropium: Works by relaxing and opening the air passages (bronchodilates) and is used to prevent wheezing, shortness of breath, coughing, and chest tightness in individuals with chronic obstructive pulmonary disease (COPD) Tolterodine: Used to treat frequent urination, urinary incontinence, or urinary urgency Trihexyphenidyl: Used to treat the symptoms of Parkinson's disease and to control extrapyramidal symptoms Trospium: Helps to relax the muscles in the bladder and reduce the daily episodes of incontinence and used to treat the symptoms of an overactive bladder, such as a frequent need to urinate or incontinence (loss of bladder control) Side Effects of Anticholinergics Like many prescription medications, anticholinergics are known to have some side effects, especially in the elderly population. When taken with antidepressants or antihistamines, side effects are more common and pronounced. Even if taken as directed, side effects can occur and include the following: Dry mouth Sore throat The inability to sweat Blurry vision Confusion Hallucinations Inability to concentrate Dizziness Increased body temperature Constipation Dry eyes Urinary retention (unable to urinate) Anticholinergic Toxicity It is difficult to understand anticholinergics without understanding anticholinergic toxicity, which occurs when an individual ingests more than the prescribed amount of anticholinergic medication. Anticholinergic Syndrome Anticholinergic syndrome (ACS), commonly known as anticholinergic toxicity most commonly occurs due to intentional overdose, accidental ingestion, taking the wrong dose at the wrong time (medical noncompliance), or in elderly individuals when they have too many prescriptions to keep up with (polypharmacy). Anticholinergic Toxidrome There is a common anticholinergic toxidrome that represents the most common symptoms associated with anticholinergic toxicity (anticholinergic syndrome): “Hot as a desert”: Hyperthermia (dangerous increase in body temperature) “Blind as a bat”: Blurry vision “Mad as a hatter”: Confusion “Dry as a bone”: Urinary retention and dry mouth “Red as a beet”: Flushed skin Individuals with severe poisoning can present with the above warning signs in addition to loss of consciousness, severe psychosis, cardiac complications and impaired breathing. The individual should be rushed to the hospital and life saving measures should be started immediately. Physostigmine is the antidote of choice for anticholinergic toxicity and should be administered as soon as possible but with extreme caution as giving too much physostigmine can lead to acetylcholine toxicity (cholinergic poisoning). What to Do If You Experience Side Effects As with any prescription or over the counter medication, it is important to follow specific directions on the box or from your healthcare provider and take as directed. If you are taking your anticholinergic as directed but are experiencing side effects that are affecting your daily life, it is important to discuss this with your healthcare provider. By weighing the pros and cons of the anticholinergic side effect, your healthcare provider can find the right medication and dosage by which to deliver treatment without the burden of side effects. Sometimes minimal side effects can be tolerated in order for you to receive the best treatment. Your healthcare provider may choose to decrease the dosage of your current anticholinergic, switch to a different anticholinergic (some specific anticholinergics have a higher likelihood of side effects than others), or stop the medication and switch you to a different class of drugs to treat your disorder. It is important to not discontinue your anticholinergics or any other prescription medication without first speaking to your provider. There are some prescription medications that must be slowly tapered off in order to prevent dangerous withdrawal effects. What Is Drug Withdrawal? Was this page helpful? Thanks for your feedback! Everything feels more challenging when you're dealing with depression. Get our free guide when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.