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Misuse of Anticholinergic Medications: A Systematic Review

Stefania Chiappini Orcid Logo, Alessio Mosca Orcid Logo, Andrea Miuli Orcid Logo, Francesco Maria Semeraro, Gianluca Mancusi, Maria Chiara Santovito, Francesco Di Carlo Orcid Logo, Mauro Pettorruso Orcid Logo, Amira Guirguis Orcid Logo, John Martin Corkery Orcid Logo, Giovanni Martinotti Orcid Logo, Fabrizio Schifano, Massimo Di Giannantonio

Biomedicines, Volume: 10, Issue: 2, Start page: 355

Swansea University Author: Amira Guirguis Orcid Logo

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Abstract

(1) Background: Over the last decade, misuse and diversion of medications has appeared to be increasingly concerning phenomena, including a range of different molecules. As current knowledge on the abuse of centrally acting anticholinergics is limited, the aim of the present study is to review the r...

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Published in: Biomedicines
ISSN: 2227-9059
Published: UK MDPI AG 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59266
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Abstract: (1) Background: Over the last decade, misuse and diversion of medications has appeared to be increasingly concerning phenomena, including a range of different molecules. As current knowledge on the abuse of centrally acting anticholinergics is limited, the aim of the present study is to review the relevant published data, focusing on the following molecules: benztropine, biperiden, scopolamine, orphenadrine, and benzhexol/trihexyphenidyl (THP). (2) Methods: A systematic literature review was carried out using Pubmed, Scopus, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Research methods were registered on PROSPERO (CRD42021257293). (3) Results: A total of 48 articles, including case reports, surveys, and retrospective case series analyses, were included. Most articles focused on benzhexol/THP (n = 25), and benztropine (n = 4). The routes of administration were mostly oral, and macrodoses together concomitant illicit drugs, e.g., cocaine, have been recorded. Toxidromes included both physical (e.g., tachycardia, tachypnoea, dilatated pupils, dry skin, urinary retention, ataxia, etc.) and psychiatric symptoms (e.g., anxiety, agitation, delirium, etc.). Fatal outcomes were very rare but reported. (4) Conclusion: Results from the present study show that anticholinergic misusing issues are both widespread worldwide and popular. Considering the potential adverse effects associated, healthcare professionals should be vigilant and monitor eventual misusing issues.
Keywords: anticholinergic drugs; drug misuse; drug abuse; drug diversion
College: Swansea University Medical School
Issue: 2
Start Page: 355