This article
talks about using anticholinergic agents to treat Parkinson's
disease. They are used in Parkinson's mainly to treat the
tremor and stiffness especially with younger patients. Older
patients are more sensitive to this type of medication, making it
less useful to them. The liklihood of medication caused
side-effects are also increased in the elderly.
Anticholinergic agents basically block the action of the
neurotransmitter acetylcholine. In Parkinson's disease this
improves the balance between the acetylcholine and dopamine
neurotransmitters and calms physical tremors.
In Alzheimer's the problem is one of acetylcholine supply.
Use of anticholinergics worsens the neurotransmitter unbalance
between acetylcholine and dopamine and interferes with any
attempts to increase acetylcholine in the brain or to improve the
sensitivity of its chemical receptors.
Progressive Supranuclear Palsy, like Parkinson's Disease usually has a problem with dopamine. Additionally, like Alzheimer's it also has a problem with acetylcholine. If that was not enough PSP usually has a problem with a third neurotransmitter named GABA.
Any use of anticholinergic drugs to improve the balance of neurotransmitters may sometimes appear to help the patient short-term. Long-term the patient's symptoms may worsen and even appear to mimic some other neurological disease since the balance between neurotransmitters will change. Since acetylcholine will
be increasingly blocked symptoms that mimic Alzheimer's may develop.
There is yet another problem in that any attempt to
increase the usable acetylcholine in the brain or to improve the
action of the acetylcholine receptors will be blocked by the use
of anticholinergic agents.
Generally, use of anticholinergic drugs should only be
considered when there is no other alternative. If used, they
should be used for the shortest time possible. Long-term use of
these drugs will tend to speed-up the progression of
Alzheimer's and Progressive Supranuclear Palsy and to
increase the probability of dementia.
The following paragraphs address the use of anticholinergic agents to treat Parkinsons disease.
Here are a few typical anticholinergic agents. In addition to these many antihistamines, antidepressants, cough and cold medications (both prescribed and over-the-counter) have anticholinergic properties.
| Brand
Name Akineton® Artane® Benadryl® Cogentin® Kemadrin® |
Generic biperiden trihexyphenidyl diphenhydramine benztropine procyclidine |
Anticholinergic agents should be started at low dosages. They may be the first therapy used or added to other treatments for Parkinson's, such as Sinemet® (levodopa). Anticholinergic agents are taken one to several times a day. They should be taken with food to lessen the chance of an upset stomach.
If you miss a dose of this medication, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to the dosing schedule. Do not double your dose. It is very important to take your medication exactly as directed by your doctor. NEVER stop taking your prescription medications without talking with your doctor.
More Common:
Less Common:
Anticholinergics may decrease the effects of:
Anticholinergics may increase the effects of:
These medications are often used to treat the Parkinsonian-like side effects that occur with the use of some antipsychotic medications (used to treat certain mental conditions) or medications to prevent nausea.
Anticholinergic agents do not work for everyone. Talk to your doctor if your symptoms do not improve. You may be able to take something that will work better for you.
Warning - These agents should be used for short term only. Use carefully if you have any of the following conditions: