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Anticholinergic Agents for Parkinson's Disease

Anticholinergic Agents for Parkinson's Disease

Examples

Generic Name Brand Name
benztropine  
biperiden Akineton
procyclidine  
trihexyphenidyl  

How It Works

Anticholinergic medicines block nerve impulses (cholinergic nerve impulses) that help control the muscles of the arms, legs, and body. They also restrict the action of acetylcholine, an important chemical messenger in the brain (like dopamine ) that helps regulate muscle movement, sweat gland function, and intestinal function.

For normal motor or muscle control, the effects of acetylcholine and dopamine need to be carefully balanced. When dopamine levels are low (as they are in people who have Parkinson's disease ), a chemical imbalance results, causing symptoms such as tremor and rigid muscles. Anticholinergic medicines decrease levels of acetylcholine to achieve a closer balance with dopamine levels.

Why It Is Used

Anticholinergics may be used in younger people who have Parkinson's disease and whose main symptom is tremor.

How Well It Works

There is some evidence that anticholinergics work well to control tremor in Parkinson's disease. 1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Signs of an overdose, such as:
    • Seizures.
    • Severe drowsiness.
    • Fast heartbeat.
    • Hallucinations.
    • Mood or mental changes.
    • Unusual warmth, dryness, or flushing of the skin.

Call your doctor if you have:

  • Hives.
  • Eye pain.
  • Confusion.
  • Skin rash.

Common side effects of this medicine include:

  • Blurred vision.
  • Constipation.
  • Decreased sweating.
  • Difficult or painful urination.
  • Dry mouth, nose, or throat.
  • Increased sensitivity of the eyes to light.
  • Nausea or vomiting.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Dry mouth is common with these medicines. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple of weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.

People who take anticholinergics need to be careful while driving or performing other tasks that require alertness, because these medicines may impair mental and physical abilities.

If you have the eye disease glaucoma, talk with an eye doctor before you start taking anticholinergics. People who have glaucoma may need to be watched more closely while they are taking these medicines. Your doctor may want you to have your eyes examined before starting this medicine and again during treatment.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Miyasaki JM, et al. (2002). Practice parameter: Initiation of treatment for Parkinson's disease: An evidence-based review. Neurology, 58(1): 11–17.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer G. Frederick Wooten, MD - Neurology
Last Revised December 5, 2012

Last Revised: December 5, 2012

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