Systematic overview of Cochrane reviews for anticholinergic effects of antipsychotic drugs.
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.


OBJECTIVE
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.
Ozbilen
Mehmet
M
Newsam Centre, Seacroft Hospital, Leeds, United Kingdom. m.oezbilen@googlemail.com
Adams
Clive E
CE
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic; D012559:Schizophrenia / Q000188:drug therapy*; D014786:Vision Disorders / Q000139:chemically induced
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists