Managing Anticholinergic and Other Common Side Effects of Antidepressants
| Anticholinergic Side Effects | Management |
|---|---|
| Dry mouth | Use sugarless gums or candies. Carry a bottle of water and sip it frequently. Emphasize need for extra good dental and oral hygiene. Worse during the initial period of treatment. |
| Urinary retention | Report any problem on urination (e.g., dribbling, urgency, hesitancy, retention). Monitor urinary patterns, especially for confused patients. Consult prescriber if the disturbance is persistent. |
| Constipation | Monitor bowel movement patterns. Encourage high fiber diet, maintain sufficient fluid intake, and exercise regularly. Consult prescriber for possible use of stool softeners or laxatives. |
| Blurred vision | If persistent and disturbing, consult prescriber for possible medication adjustment. |
| Poor memory and concentration | ClozapineIf persistent and disturbing, consult prescriber for possible medication adjustment. |
| Sedation | Symptom will usually subside with time. Monitor sleep patterns and related habits to eliminate factors adversely affecting sleep hygiene. May need to avoid driving. |
| Weight gain | Weigh patient monthly. Monitor diet patterns. Help patient to incorporate regular exercise in daily routines. Consult prescriber if weight gain is persistent despite application of practical measures as above. |
| Sexual dysfunction | Assess baseline sexual activity level and deviation from it. Consult prescriber if the deviation is too disturbing to tolerate. |
| GI upset | Take medications with or after meals. |
| Orthostatic hypotension | Monitor orthostatic BP regularly. Instruct patient to rise slowly when changing positions and to take sufficient fluid. Consult prescriber if BP is less than 90/60. |