NeuroTalk Support Groups - Parkinson's patients should avoid anticholinergic medications

The study you kindly provided a link to, helped me to educate myself further and to find more information about anticholinergic drugs and the harms they can do to the elderly.

I had been looking for reference material on geriatric medicine, as my 84-year-old husband is currently having a bad reaction to increased doses of Madopar (levodopa/ benserazide) with sedation and a dramatic increase in psychiatric side effects including memory loss and delusions. I recently learned that, on average, people over 65 eliminate this drug about 25% slower than younger people, so I can use that to argue for lower doses.

His neurologist and other family members are pushing for him to be placed on antipsychotic drugs to deal with the side effects of the Madopar. These drugs have moderate to high anticholinergic properties. Neither my husband nor I want him to take antipsychotics, as I think he would disappear as a person. He is not a danger to himself nor others, and he absolutely does not need to be chemically restrained.

VirginiaGeriatrics.org (Virginia Commonwealth University) has excellent pages on geriatric medicine and anticholinergics. I found certain information to be very applicable to my husband's situation.

Virginia Geriatrics: Medications to Avoid in the Elderly

Anticholinergic medications are particularly problematic for the elderly.

They can cause sedation, blurred vision, urinary retention, confusion, hallucinations, dry mouth and constipation.

Anticholinergic agents are generally not well tolerated in elderly patients and should be avoided whenever possible.

Patients with delirium, dementia, constipation, and BPH are particularly at risk of anticholinergic adverse drug events.

Avoid anticholinergic medications whenever possible.

Don't prescribe anticholinergic drugs, especially to patients with delirium, dementia, constipation, or prostatic hypertrophy.

Virginia Geriatrics: Medications to Avoid in the Elderly

DON'T do any of these: prescribe a drug to treat the side effects of another drug.

DO all of these: assess whether your patient may already be suffering from an adverse drug effect before adding more drugs.