“There are so many alternatives to these drugs,” says Dr. Sarah Berry, a geriatrician and assistant professor of medicine at Harvard Medical School,

“For example, selective serotonin re-uptake inhibitors (SSRIs) like citalopram (Celexa) or fluoxetine (Prozac) are good alternatives to tricyclic antidepressants. Botox injections and cognitive behavioral training can alleviate urge incontinence.”

Of course, one might want to try to delve a little more deeply to figure out the root causes of a patient’s allergies, sleep problems, or depression.

But at the very least, clinicians should exercise a bit of prudence in prescribing or recommending anticholinergic drugs to older people, especially those with pre-existing cognitive disorders. Keep in mind that the body’s production of acetylcholine tends to diminish with age. Blocking acetylcholine’s effects with an exogenous pharmaceutical only amplifies the disadvantage for older people.

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Jeannie Hall has recently earned her Master’s degree in Nutrition and Integrative Health from Maryland University of Integrative Health (MUIH) in Laurel, MD. She is pursuing her CNS credential and is employed with Annapolis Acupuncture. Jeannie grew up on the Severn River, in Severna Park, MD and currently resides in Arnold, MD