The People's Perspective on Medicine

Anticholinergic Drugs | Dry Mouth and Alzheimer Disease?

Do you medications cause dry mouth, blurred vision and constipation? If so, you may be taking anticholinergic drugs. What can you do about a dry mouth?
Dry mouth medical concept or xerostomia due to lack of saliva as a human tongue with text as a health care symbol for oral disease or illness with 3D illustration elements.

Anticholinergic drugs are generally bad for the brain. They affect the crucial neurochemical acetylcholine. One worry about anticholinergic drugs is a link to memory problems or Alzheimer’s disease (Journal of Alzheimer’s Disease, 46(4); 2015.  How would you know whether you were taking a strong anticholinergic medication? Here are some classic side effects of such drugs: dry mouth, blurry vision, dry eyes, reduced sweating, constipation, drowsiness, and confusion.

How Would You Know If You Were Taking Anticholinergic Drugs?

You might be surprised to learn that many health professionals do not know which drugs have anticholinergic activity. They learn that a drug such as atropine plus diphenoxylate (Lomotil), prescribed for diarrhea, has strong anticholinergic activity. Ditto for scopolamine (Transderm Scop), prescribed for motion sickness.

There are scores of other drugs, though, that also have strong anticholinergic activity. Take diphenhydramine (DPH), for example. It is the antihistamine in Benadryl. This ingredient is also found in lots of OTC nighttime pain medicines. It is the “PM” in products like Tylenol PM or Aleve PM.

We have pulled together a comprehensive list of anticholinergic drugs. You can access that list at this link.  You will be astonished at how many common medications are included.

Dry Mouth and Anticholinergic Drugs | A Reader’s Question:

Q. I have a problem with dry mouth because several of the medications I take cause this side effect. My dentist’s assistant told me about a wonderful product line. I have found Biotene mouthwash and toothpaste extremely helpful.

A. Biotene products contain water, glycerin, xylitol, sorbitol and other ingredients designed to lubricate the mouth. Thanks for sharing your success.

Drug-induced dry mouth is a tip off that you may be taking anticholinergic medications. Such drugs can cause dry mouth, dry eyes and constipation. They also impact brain neurochemistry, which in turn may increase the risk of cognitive impairment and dementia (JAMA Internal Medicine, March 2015).

We have included a comprehensive list of anticholinergic drugs at this link. Ask your doctor if she could substitute alternate medicines that will not cause dry mouth symptoms.

Reports from Other Readers:

Susan in Indiana worries about her mom and anticholinergic drugs:

“My Mom is on three anticholinergic drugs. I can tell when she has taken them. She cannot process any information or remember what we talked about 5 minutes ago. I highly recommend moving to safer options if you can.”

Tony in Salisbury, Maryland, has concerns:

“I am on several medicines that are anticholinergic, especially Cogentin. The constipation required prune juice and fiber 3 times a day to fix. Cogentin had to go!

“I’ve been prescribed ziprasidone, low doses of thorazine and Benadryl for sleep.  In case those don’t work I take Ambien. The only med I take that’s not anticholinergic is lithium, to prevent mania, and it has damaged my kidneys.

“Ive been telling my doctors for a year that I’ve been having memory problems at times, and it’s like they don’t listen or care, so long as my blood pressure is good, my sleep is o.k., and I’m not crazy. Now that I’ve read this article I’m going to press for changes.”

If you would like to learn more about how anticholinergic drugs can cause symptoms like dry mouth and memory problem, listen to our free podcast with Dr. Shelly Gray at this link. Click on the green arrow above the picture of Larry Goldstein, MD, or download the free mp3 file at the bottom of the page.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I have been taking Nyquil Zzzz for quite a while. I do believe it contains Diphenhydramine HCI. It says it is non habit forming but I do not feel that I can stay asleep without it. I also have dry mouth. I am also having memory problems. It’s looks like I just need to quit taking it. I really appreciate the information that you provided.

Anticholinergics have side effects that are particularly distressing for elderly people: cognitive difficulties such as mental confusion and loss of memory and physical problems such as clumsiness, dizziness and loss of balance.

Forever Mints are also great for dry mouth. They stick to the gum line and last 3-4 hours. NeuOra makes them. They have xyitol in them & can get them with Vit D, chromium, and several other types. I’ve used these for severe dry mouth for years & love how it solves the problem, even at night.

Have dry mouth? Drink water. It will not cost thousands a year.

When dry mouth is caused by medicine, drinking water only works for a few minutes, and then your month is dry again. Don’t you think if it was that simple most people would be doing that?

You need to find another doctor who is actually interested in your well-being and sees you as not just another patient on the list for the day. Get someone who will listen and explain to you in an understanding way and cooperate with your needs and wants,

I am seeing a Rheumatologist for Sgogren’s and, of course, dry mouth is my worst situation. I am taking Pilocarpine 4 times a day, and added to my situation are dry eyes because of eye problems. For that I am taking Restasis when I can afford and sometimes get the imprimis. I also am doing autologous 4 times a day. Occasionally, because I suffer from diarrhea (colon cancer background) I take the Diphenoxylate. I also use Biotin mouthwash and toothpaste. I am 89. The only other presc. is losartan.

The list of drugs does not include doxylamine succinate which is in Kirklands Sleep Aid. Is this an oversight or is the activity of this sleep aid not considered notable?

Thank you for listing the ingredients in Biotene. I have been considering using it. I thought I read the ingredients but guess not. Biotene products contain water, glycerin, xylitol, sorbitol and other ingredients designed to lubricate the mouth. Xylitol caused a permanent problem with my intestinal tract after only encountering it in sugarless gum. Within a month, I scheduled a colonoscopy. I am not taking an anticholinergic.

The xylitol in Biotene products is NOT a problem to the digestive tract if you do not swallow the products! Biotene products are not supposed to be swallowed!

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