Characterizing anticholinergic abuse in community mental health

Barbara G. Wells, Patricia A. Marken, Lucy A. Rickman, Candace Brown, Gale Hamann, Jana Grimmig

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

To identify factors associated with anticholinergic abuse in patients taking antipsychotics and anticholinergics and to document the extent of extrapyramidal side effects in anticholinergic abusers, 21 anticholinergic abusers were matched with 21 controls without a history of anticholinergic abuse for diagnosis and antipsychotic dose. Data were collected prospectively, and extrapyramidal side effects and abnormal involuntary movements were evaluated using the Modified Simpson Angus Scale and the Abnormal Involuntary Movement Scale. The abuse group reported significantly more subjective effects from anticholinergic agents than did those in the control group (mean ± SD = 10.5 ± 5.4 vs. 6.5 ± 3.7, p < 0.05). The abuse group was significantly more likely to report feeling a buzz (p < 0.05) and difficulty learning (p < 0.05) when taking anticholinergic medications. Abusers reported abusing significantly more drugs in the past (2.7 ± 2.1 vs. 0.8 ± 0.9, p < 0.01) and had taken antipsychotics (12.7 ± 6.3 vs. 8.7 ± 5.4 years, p < 0.05) and anticholinergics (10.9 ± 3.1 vs. 6.1 ± 4.6 years, p < 0.01) significantly longer than controls had. Patients in the control group spent significantly more years working full-time than did abusers (6.2 ± 7.3 vs. 0.7 ± 1.4, p < 0.01). There was a nonsignificant trend for abusers with a longer duration of antipsychotic use to have higher Abnormal Involuntary Movement Scale scores (r = 0.40, p < 0.10). Although these drugs are potentially abusable, the term “anticholinergic abuse” should be reevaluated in light of accumulating evidence that many patients taking these drugs report improved functioning, with improvement in negative symptoms and minimal or no adverse anticholinergic effects.

Original languageEnglish (US)
Pages (from-to)431-435
Number of pages5
JournalJournal of Clinical Psychopharmacology
Volume9
Issue number6
StatePublished - Jan 1 1989

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Cholinergic Antagonists
Mental Health
Antipsychotic Agents
Dyskinesias
Pharmaceutical Preparations
Control Groups
Emotions
Learning

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Wells, B. G., Marken, P. A., Rickman, L. A., Brown, C., Hamann, G., & Grimmig, J. (1989). Characterizing anticholinergic abuse in community mental health. Journal of Clinical Psychopharmacology, 9(6), 431-435.

Characterizing anticholinergic abuse in community mental health. / Wells, Barbara G.; Marken, Patricia A.; Rickman, Lucy A.; Brown, Candace; Hamann, Gale; Grimmig, Jana.

In: Journal of Clinical Psychopharmacology, Vol. 9, No. 6, 01.01.1989, p. 431-435.

Research output: Contribution to journalArticle

Wells, BG, Marken, PA, Rickman, LA, Brown, C, Hamann, G & Grimmig, J 1989, 'Characterizing anticholinergic abuse in community mental health', Journal of Clinical Psychopharmacology, vol. 9, no. 6, pp. 431-435.
Wells, Barbara G. ; Marken, Patricia A. ; Rickman, Lucy A. ; Brown, Candace ; Hamann, Gale ; Grimmig, Jana. / Characterizing anticholinergic abuse in community mental health. In: Journal of Clinical Psychopharmacology. 1989 ; Vol. 9, No. 6. pp. 431-435.
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