Section - Quick Takes

02. Misuse of Anticholinergic Medications: A Systematic Review

Published on September 1, 2022 Certification expiration date: September 1, 2028

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Misuse of anticholinergic medications is not common but worth being aware of, including the potential for withdrawal symptoms in hospitalized patients.

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Diversion of stimulants is rampant among college students, and misuse of benzodiazepines is a constant concern. But how often are anticholinergics diverted or abused? They’re essential medications for some patients who otherwise would experience extrapyramidal symptoms due to their antipsychotics. Just how much should you worry about their misuse?

Hi! Jim Phelps here for the Psychopharmacology Institute. I’ll admit, I’m not very streetwise. Most everything I know about misuse of drugs has come from listening to my patients, and I’ve not heard about anticholinergic abuse. So, how naïve am I?

Well, here’s an article on the subject. It begins by referencing the European Monitoring Centre for Drugs and Addiction. Let’s have a quick look at this website. We see opioids, benzos, Z-drugs, and stimulants, which is no surprise. The over-the-counter list includes dextromethorphan from cough syrup and antihistamines like diphenhydramine, even loperamide. Then there’s pregabalin and gabapentin but no mention

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03. Optimal Doses of Specific Antipsychotics for Relapse Prevention in a Nationwide Cohort of Patients With Schizophrenia

Learning Objectives:

After completing this activity, the learner will be able to:

Examine proposed clinical guidelines for the management of clozapine risks during medication titration.
Consider the frequency of anticholinergic misuse relative to other commonly used substances.
Examine rehospitalization rates for patients with first-episode schizophrenia diagnoses and possible implications for antipsychotic dosing for relapse prevention.
Review the impact of metformin in psychiatric patients across 3 studies for the prevention of clozapine-induced weight gain.
Examine findings in a recent systematic umbrella review tackling the serotonin hypothesis of depression.

Original Release Date: September 1, 2022

Review and Re-release Date: September 1, 2025

Expiration Date: September 1, 2028

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.