Drugs that are used to treat common conditions such as bladder problems, depression and insomnia could delay recovery time for brain injury patients. These medications with anticholinergic properties are prescribed to as many as 50 percent of older people, according to research by University of East Anglia (UEA) and University of Aberdeen scientists, published in Brain Injury and reported in Drug Discovery & Development (https://www.dddmag.com/news/2015/08/common-medications-could-delay-brain-injury-recovery?et_cid=4731052&et_rid=45505806&location=top).
Anticholinergics block the action of the neurotransmitter acetylcholine in the brain, according to Healthline. Used to treat diseases like asthma, incontinence, gastrointestinal cramps, and muscular spasms, they are also prescribed for depression and sleep disorders. Anticholinergics help to block involuntary movements of the muscles associated with these diseases and balance the production of dopamine and acetylcholine in the body. They can also be used to treat certain types of toxic poisoning, and are sometimes used as an aid to anesthesia
These medications are frequently used on neuro-rehabilitation units to manage symptoms from urinary incontinence to pain. While anticholinergics are known to have side effects such as temporary cognitive impairment, dizziness and confusion, their effects on people with pre-existing brain and spinal injuries have not been investigated before.
Conducted by the University of East Anglia, the study of 52 patients with acquired brain or spinal injury at a neuro-rehabilitation unit demonstrated that “the average length of stay was longer in patients with a higher level of anticholinergic drugs in their system, known as the anticholinergic drug burden, or ACB.” Professor Phyo Myint, chair of old age medicine at the University of Aberdeen has conducted a number of previous studies examining the effect of medications with anti-cholinergic properties. He analyzed the results with Dr. Chris Fox, professor of clinical psychiatry at the Norwich Medical School at UEA.
The researchers indicated that the change in ACB correlated directly to the length of hospital stay. “A higher ACB score on discharge, compared with on admission, was associated with a longer stay in hospital and a lower ACB on discharge saw on average a shorter stay,” the article said. While the researchers said that cause-and-effect relationship cannot be implied, Dr Fox, lead author on the paper, believes that “The findings suggest there may be a statistically significant relationship between ACB score and length of stay in a neuro-rehabilitation unit following traumatic brain or spinal cord injury”.
According to Dr. Fox, “This pilot study demonstrates the need for larger studies to confirm the results and need for further investigation into what long-term effects these common medications are having on the recovery of these patients. nWhile medications with ACB are often needed to treat common complications of brain or spinal cord injuries, cognitive impairment due to the medication may adversely affect a patient’s ability to engage in the rehabilitation process, potentially increasing their length of stay in hospital.”
