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Anticholinergics generally have antisialagogue effects (decreasing saliva production), and most have at least some sedative effect, both being advantageous in surgical procedures.
When a significant amount of an anticholinergic is taken into the body, a toxic reaction known as acute anticholinergic syndrome may result. This may happen accidentally or intentionally as a consequence of recreational drug use. Anticholinergic drugs are usually considered the least enjoyable by many recreational drug users, possibly due to the lack of euphoria caused by them. In terms of recreational use, these drugs are commonly referred to as deliriants. Because most users do not enjoy the experience, they do not use it again, or do so very rarely. The risk of addiction is low in the anticholinergic class. The effects are usually more pronounced in the elderly, due to natural reduction of acetylcholine production associated with age.
Hallucinated presence of people not actually there
Rarely: seizures, coma, and death
Orthostatic hypotension (sudden dropping of systolic blood pressure when standing up suddenly) and significantly increased risk of falls in the elderly population.
A common mnemonic for the main features of anticholinergic syndrome is the following:
Hot as a hare (hyperthermia)
Blind as a bat (dilated pupils)
Dry as a bone (dry skin)
Red as a beet (vasodilation)
Mad as a hatter (hallucinations/agitation)
The bowel and bladder lose their tone and the heart goes on alone (ileus, urinary retention, tachycardia)
Acute anticholinergic syndrome is completely reversible and subsides once all of the causative agent has been excreted. Reversible cholinergic agents such as physostigmine can be used in life-threatening cases. Wider use is discouraged due to the significant side effects, such as rapid heart beat and decreased blood pressure.
Piracetam (and other racetams), Alpha-GPC and Choline are known to activate cholinergic system and alleviate cognitive symptoms caused by extended use of anticholinergic drugs.
The most common plants containing anticholinergic alkaloids are: