The following is a summary of “Anticholinergic Medications and Parent-Reported Anticholinergic Symptoms in Neurologically Impaired Children,” published in the FEBRUARY 2023 issue of Pain Management by Feinstein, et al.

Anticholinergic (AC) drugs are given to children who have significant neurological impairment and polypharmacy; however, it was not well understood. Scores ≥3 on the Anticholinergic Cognitive Burden (ACB) scale, which assesses the overall anticholinergic burden of a drug regimen, have been linked to higher rates of morbidity and death in adults. For a study, researchers examined the connection between children’s parent-reported anticholinergic symptoms and ACB scores.

A cross-sectional research included patients aged 1 to 18 with significant neurological impairment as determined by the ICD and polypharmacy Total ACB ratings for all drugs were calculated during normal clinical visits. They evaluated the symptoms of AC that parents mentioned, such as constipation, tiredness, trouble focusing, dry mouth, or urinary issues. After adjusting for age and recent acute healthcare usage, multivariable logistic regression was performed to examine the relationship between total ACB scores ≥3 for planned drugs and the existence of AC symptoms.

Among 123 distinct patients, 87% had AC prescriptions. Systemic antihistamines (64%), anxiolytics (53%), antidepressants (30%), H2 blockers (22%), and muscle relaxants (20%) were among the most popular groups of AC medications. For scheduled drugs, total ACB scores ≥3 were seen in 44% of patients and in 63% of patients for scheduled plus PRN meds. Total ACB scores ≥3 were significantly linked with an increased likelihood of ≥1 anticholinergic symptom for both scheduled (OR: 3.1; 95% CI: 1.4, 6.7) and scheduled plus PRN drugs (OR: 2.9; 95% CI: 1.3, 6.4).

If confirmed in broader populations, the correlation between increased overall ACB scores and anticholinergic adverse effects in children might lead doctors to rethink prescription anticholinergic drugs that may not be necessary.