Systematic Overview of Cochrane Reviews for Anticholinergic Effects of Antipsychotic Drugs
Abstract
BACKGROUND: Despite much being written on the topic, there are few surveys investigating the prevalence of anticholinergic adverse effects of antipsychotic drugs. One study, however, used trial-derived data to calculate estimates. OBJECTIVES: To investigate the prevalence/incidence rates of anticholinergic effects as viewed from within relevant randomized trials. METHODS: Data were extracted from each relevant study included in Cochrane reviews. Data were checked, extracted, and simple frequencies, and 95% confidence intervals (CIs) were calculated. RESULTS: Many trials in relevant reviews reported no data on anticholinergic effects (estimate 40,000 participants). However, data were extracted from 177 studies within 54 reviews (N = 27,328 participants). Most data are short-term (<12 weeks). For blurred vision, the newer generations of drugs have rates of between 10% and 20% (eg, risperidone, n = 1460, 6 randomized controlled trials [RCTs], 11.9% prevalence; CI, 10-14; olanzapine, n = 1584; 4 RCTs, 12.2% prevalence; CI, 11-14). These estimates are similar to those of sulpiride (n = 186; 2 RCTs, 12.4%; CI, 8-18) and chlorpromazine (n = 294; 10 RCTs, 11.2%; CI, 8-15), less than trifluoperazine (n = 167; 8 RCTs, 31.1%; CI, 25-39), but considerably more than perphenazine (n = 410; 8 RCTs, 3.7%; CI, 2-6). Data are presented on a range of anticholinergic effects across different periods. CONCLUSIONS: Anticholinergic symptoms are common adverse effects associated with the use of all antipsychotic drugs, and newer-generation drugs are not clearly distinguishable from many older compounds. Adverse effect data should be more accessible.
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Prevalence of constipation in randomized controlled trials for different antipsychotics is: zotepine 39.6%, clozapine 21.3%, haloperidol 14.6% and risperidone 12%.
“Prevalence of constipation in randomized controlled trials for different AP is: zotepine 39.6%, clozapine 21.3%, haloperidol 14.6% and risperidone 12% (583).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [583]
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
Correll, C. U., Detraux, J., De Lepeleire, J., & De Hert, M. (2015) · World Psychiatry · doi:10.1002/wps.20204 · Cited by 820 · see citing works
- Authors
- Ozbilen, M., & Adams, C. E.
- Affiliations
- Seacroft Hospital (GB)
- University of Nottingham (GB)
- Corresponding author
- Ozbilen, Mehmet
- ORCID
- Adams, Clive E.
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2009-04
- Volume
- 29
- Issue
- 2
- Pages
- 141-146
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W2009542905
- Cited by
- 74
- References
- 28
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 10 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 11 · 2015: 5 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- AstraZeneca
- University of Leeds
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Keywords
- anticholinergic effects, antipsychotic drugs, adverse drug reactions, blurred vision, risperidone, olanzapine, chlorpromazine, trifluoperazine, perphenazine, sulpiride
- MeSH terms
- Humans, Review Literature as Topic, Schizophrenia, Antipsychotic Agents, Vision Disorders, Randomized Controlled Trials as Topic, Cholinergic Antagonists
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