Chronic exposure to anticholinergic medications adversely affects the course of Alzheimer disease

Am J Geriatr Psychiatry. 2003 Jul-Aug;11(4):458-61.


Objective: Authors examined the effect of chronic exposure to anticholinergics in a cohort of Alzheimer disease (AD) patients.

Methods: All patients were examined annually with standard neuropsychologic tests and received the cholinesterase inhibitor donepezil hydrochloride at a dose of 10 mg/day. The study population (N=69) was divided into two groups: those receiving one or more concomitant medications with significant anticholinergic properties (N=16) and those receiving no concomitant medications with anticholinergic properties (N=53).

Results: At 2 years, MMSE scores were significantly worse for patients receiving anticholinergic medications than for those not on anticholinergics.

Conclusion: Although very preliminary, these data suggest that concomitant therapy with anticholinergics may be associated with significant deleterious effects on acetylcholinesterase therapy, or, more speculatively, that chronic exposure to anticholinergics may have adverse effects on the clinical course of AD.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / psychology
  • Cholinesterase Inhibitors / administration & dosage
  • Cholinesterase Inhibitors / adverse effects
  • Cholinesterase Inhibitors / therapeutic use*
  • Donepezil
  • Drug Administration Schedule
  • Female
  • Humans
  • Indans / administration & dosage
  • Indans / adverse effects
  • Indans / therapeutic use*
  • Male
  • Piperidines / administration & dosage
  • Piperidines / adverse effects
  • Piperidines / therapeutic use*
  • Psychomotor Agitation / epidemiology
  • Psychomotor Agitation / etiology
  • Retrospective Studies


  • Cholinesterase Inhibitors
  • Indans
  • Piperidines
  • Donepezil