Anticholinergic burden
Some medicines can block a natural chemical in the body called acetylcholine, which helps with memory, thinking, bladder control, and digestion.
When you take one or more of these medicines, their effects can add up.
This total effect is called your anticholinergic burden.
Why is this important?
A high anticholinergic burden can cause:
- Forgetfulness or confusion
- Feeling drowsy or slowed down
- Dry mouth
- Constipation
- Blurred vision
- Difficulty passing urine
- Feeling unsteady or having more falls
Older adults are especially sensitive to these effects.
Which medicines can contribute?
Examples include:
- Some antidepressants
- Medicines for bladder urgency
- Some antihistamines (including sleep aids)
- Medicines for stomach cramps or IBS
- Travel sickness tablets
- Certain pain medicines
Your GP or pharmacist can check your full list using an ACB score.
What can you do?
✔ Tell your GP or pharmacist about all medicines you take
This includes prescribed, over‑the‑counter, herbal, and “as needed” medicines.
✔ Ask if any medicines can be reduced or changed
Sometimes a lower dose or safer alternative is possible.
✔ Watch for side effects
Report new confusion, falls, severe constipation, or trouble passing urine.
✔ Do not stop medicines suddenly
Always speak to a healthcare professional first.
When to seek help
Contact your GP, pharmacist, or NHS 111 if you experience:
- Sudden confusion
- Severe constipation
- Difficulty passing urine
- A fall or injury
- New or worsening memory problems