Skip to content

A Risky Mix of Meds

If you read the print-outs your pharmacist dispenses along with new-to-you prescription medications, you probably know that dry mouth seems to be on the list of possible side-effects for a lot of different medications.

Often, that’s because the pill in question blocks acetylcholine, a chemical messenger that plays a key role in producing secretions such as saliva, in addition to other functions, such as regulating heart rate, alertness, and the activity of smooth muscle cells such as those involved in bladder control.

Those multiple functions means that so-called anticholinergic medications can cause side effects ranging from fuzzy thinking and drowsiness to dry eye. 

And since a wide array of drugs (both prescription and non) in different classes fall into this category, people can easily end up taking more than one, thereby increasing the likelihood of experiencing such problems. (That’s to say nothing of the possible link between taking these medications for long periods and dementia.) Age-related changes in the way our bodies break down medications also increase the risk.

I was aware of these facts when I started doing background research for a story on anticholinergic medications. Still, I was shocked when I plugged the names of my own medications into an online tool that calculates the combined anticholinergic ‘burden’. 

Gulp. Experts recommend keeping this number below three if you’re 65 or older. My score? Four. Had I known that, I probably would have ditched the daily antihistamine a long time ago.

You can find out more about the potential risks of multiple anticholinergic drugs in this piece I wrote for Good Times‘ latest (May/June) issue: ‘A Risky Mix of Meds.’

My heartfelt thanks to the interviewees who so generously shared their time and expertise:

Camille Gagnon, PharmD, assistant director of the Canadian Deprescribing Network, at the Institut universitaire de gériatrié de Montréal, in Montreal.

Dr. Rita McCracken, a family physician, assistant professor of family practice, and member of the Therapeutics Initiative at the University of British Columbia in Vancouver.

Dr. Dee Mangin, a professor in the Department of Family Medicine at McMaster University in Hamilton, Ont. Dr. Is also the associate chair of research in the department, where she holds the David Braley Chair in Family Medicine.


ACB (Anticholinergic Burden) Calculator

Canadian Deprescribing Network


How Well Do You Know Your Anticholinergic (antimuscarinic) Drugs?

Photo by Adam Nieścioruk Courtesy of Unsplash