OBJECTIVE To compare the effect of individual educational visits versus group visits using academic detailing to discuss prescribing of highly anticholinergic antidepressants in elderly people. DESIGN Randomised controlled trial with three arms (individual visits, group visits, and a control arm). SETTING Southwest Netherlands. PARTICIPANTS 190 general practitioners and 37 pharmacists org...

1. Manivel S, Prasad R, Jacob R. Anesthetic management of a child with Klippel-Feil syndrome in the radiology suite. Paediatr Anaesth. 2005;15:171--2. 2. Cakmakkaya OS, Kaya G, Altintas F, et al. Anesthetic management of a child with Arnold-Chiari malformation and Klippel-Feil syndrome. Paediatr Anaesth. 2006;16:355--6. 3. Subramanyam R, Cudilo EM, Hossain MM, et al. To pretreat or not to pretr...

BACKGROUND Older people are commonly prescribed multiple medications, including medications with anticholinergic effects. Polypharmacy and anticholinergic medications may be risk factors for the development of delirium. METHODS Patients from a medical admission unit who were over 70, with DSM-IV diagnosed delirium and patients without delirium, were investigated. Number of drugs prescribed on...

It is well documented that the antipsychotic medications, i.e., the pheno-thiazines and butyrophenones, offer considerable risk of permanent injury to the liver, skin, cornea, bone marrow, heart, and especially to the nervous system. Tardive dyskinesia, a prolonged and sometimes permanent extrapyramidal syndrome, has been reported in up to 50 percent of patients over age 60 who have been treate...

BACKGROUND The prescribing cascade model involves the misinterpretation of an adverse reaction to 1 drug and the subsequent, potentially inappropriate prescription of a second drug. We present a new example of the prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs used to manage urinary incontinence. METHODS A population-based retrospective cohort study was carr...

Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biper...

Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as p...

OBJECTIVES To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. DESIGN A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. SETTING Community-dwelling and...

OBJECTIVE The authors' goals were 1) to establish a clinically useful standard index of the relative anticholinergic potency of psychiatric medications; 2) to determine which cognitive functions are most affected by the administration of anticholinergic medications to patients with schizophrenia; and 3) to compare in vitro and clinically derived indexes of anticholinergic load in predicting the...

Bladder pain syndrome/interstitial cystitis is a condition characterized by chronic pelvic and bladder (lasting longer than 6 months) accompanied urinary symptoms (urinary frequency, urgency nocturia). It can have highly negative effect on the quality of life. The treatment this disease impeded lack understanding its etiology. Therefore, recommendations information about their efficacy are scar...