Are anticholinergic medications being well used? a systematic review
DOI:
https://doi.org/10.25118/2236-918X-7-3-3Keywords:
Cholinergic antagonists, anti psychoti c agents, movement disordersAbstract
Anti psychoti cs are used to treat several mental disorders, making it imperati ve to study their adverse eff ects in an att empt to alleviate symptoms and thus improve treatment adherence. Movement disorders are common adverse eff ects of these drugs, and their approach is generally based on dose reducti on, change of anti psychoti c drug, and/or introducti on of an anti cholinergic medicati on. The objecti ve of this study was to perform a systemati c review on the use of anti cholinergic medicati ons for the management of extrapyramidal symptoms caused by anti psychoti cs. This review will enable a criti cal analysis of such use. The literature was searched using the PubMed and SciELO databases. Out of 318 arti cles retrieved, 24 were included in the review. The papers were organized according to the following topics: anti cholinergic eff ects of anti psychoti cs; movement disorders; typical and atypical anti psychoti cs; anti psychoti c polypharmacy; chronic use and disconti nuati on of anti cholinergics. The anti psychoti c drug in use and the combined use of these medicati ons may infl uence the prescripti on of anti cholinergic medicati ons and the presence of extrapyramidal symptoms. Before starti ng to use an anti cholinergic medicati on, it is important that the clinician consider changing the anti psychoti c in use or reducing its dose. The need for anti cholinergic medicati ons should be regularly revised, and, whenever possible, gradually withdrawn. Prophylacti c use of these drugs is contraindicated, and its therapeuti c use should be avoided in the elderly and in pati ents with tardive dyskinesia.
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