Acetylcholine and DeliriumTune L.E. · Egeli S.
Division of Geriatric Psychiatry, Wesley Woods Center at Emory University, Atlanta, Ga., USA
The neurotransmitter acetylcholine has been implicated in animal and human studies of delirium. This chapter will briefly review the clinical studies focussing on measurement of serum levels of anticholinergic activity in delirious states. Three approaches have been taken. First, to identify medications currently prescribed that have subtle anticholinergic effects. The current ‘list’ includes 48 commonly prescribed medications. Second, to associate serum anticholinergic activity with delirium in various clinical states including postcardiotomy delirium, postelectroconvulsive delirium, delirious elderly medical inpatients, and nursing home patients. Third, to intervene in patients with elevated anticholinergic activity by reducing known anticholinergics and correlating this reduction with clinical measures of cognition and delirium. Our most recent data investigates the impact of anticholinergics on demented patients. Rates of delirium were significantly higher in patients receiving larger numbers of anticholinergics.
Larry E. Tune, MD
Division of Geriatric Psychiatry
Wesley Woods Center at Emory University
1841 Clifton Road NE, Atlanta, GA 30329 (USA)
Tel. +1 404 728 4960, Fax +1 404 728 4963
Number of Print Pages : 3
Number of Figures : 0, Number of Tables : 3, Number of References : 9
Dementia and Geriatric Cognitive Disorders
Vol. 10, No. 5, Year 1999 (Cover Date: September-October 1999)
Journal Editor: V. Chan-Palay, New York, N.Y.
ISSN: 1420–8008 (print), 1421–9824 (Online)
For additional information: http://www.karger.com/journals/dem