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Anticholinergic Effects of Oral Antipsychotic Drugs of Typicals Versus Atypicals Over Medium- and Long-Term: Systematic Review and Meta-Analysis

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Background: Anticholinergic side-effects of antipsychotic drugs are common and can potentially impact on quality of life as well as concordance with medication. Objectives: To investigate prevalence/incidence rates of anticholinergic side-effects of oral antipsychotic drugs over the medium- and long-term. Methods: We included all systematic reviews undertaken by the Cochrane Schizophrenia Group for people who are taking antipsychotic drugs and suffering from schizophrenia or Schizophrenia-like illnesses. The prevalence/ incidence of any anticholinergic side-effects was calculated. Relevant papers from the Cochrane Database were identified in January 2007 and the data was pooled. Side-effect data was grouped into the medium (3-6 months) and long-term (>6 months). We calculated simple frequencies, proportions and confidence intervals. We undertook a comparison within the group and generated a Forrest plot of the data. Results: We identified 177 studies within 54 reviews (N=27328 participants). Anticholinergic side-effects for blurred vision, dry mouth and constipation manifested for antipsychotics ranging from 1 to 40 % over the medium-term and 1 to 41% over long-term respectively. There were no statistical differences beween typicals and atypicals over medium- and long-term. Conclusion: To the best of our knowledge, we have collated the largest amount of data on anticholinergic side-effects for antipsychotics over the medium- and longterm. Anticholinergic side-effects are common over the medium- and long-term. Over the medium- and long-term there were no statistically significant differences between the typicals and atypicals in the main anticholinergic side-effects with one exception. We found that in the long-term, the typical antipsychotics were associated with a significantly higher prevalence of blurred vision.
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Keywords: Anticholinergic effects; Cochrane Schizophrenia; Forrest plot; antipsychotic drugs; blurred vision; constipation; dry mouth; prevalence/incidence; schizophrenia; trials

Document Type: Research Article

Publication date: 01 October 2012

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  • Current Medicinal Chemistry covers all the latest and outstanding developments in medicinal chemistry and rational drug design. Each issue contains a series of timely in-depth reviews written by leaders in the field covering a range of the current topics in medicinal chemistry. Current Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments.
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