Anticholinergic adverse effects of antipsychotics

For advice on monitoring for and preventing antipsychotic adverse effects, see Overview of antipsychotic adverse effects.

Treat mild peripheral anticholinergic effects (eg blurred vision, urinary hesitancy) symptomatically. Also see constipation, dry mouth and dry skin.

Urgent review and intervention is required for severe anticholinergic effects such as increased intraocular pressure, faecal impaction (see here for adults and here for children), delirium and cognitive impairment.

If anticholinergic adverse effects are severe or intolerable, options include:

• reducing the dose of or stopping other anticholinergic drugs
• reducing the antipsychotic dose
• switching to an antipsychotic less likely to cause anticholinergic adverse effects, if the above measures are ineffective or impractical—see Approximate relative frequency of common adverse effects of antipsychotics for approximate relative frequencies of anticholinergic effects.

Anticholinergic toxicity can occur with large doses of antipsychotics (eg overdose)—for management, see here.