Brain injury recovery may be hampered by commonly used drugs

10 Aug

New research reveals that a class of drugs prescribed to treat common

conditions ranging from bladder problems, depression and insomnia in up to 50% of

older patients may delay their recovery from brain injury.

brain and spinal cord
Drugs commonly used to treat complications of brain and spinal cord injuries may prolong rehabilitation, a new study suggests.

Anticholinergics are already known to have side effects, including temporary

cognitive impairment, confusion and dizziness. But the new study led by the

University of East Anglia (UEA) in the UK is the first to investigate their effects

on patients with brain injury.

The researchers, including scientists from Aston University, other UK research

centers and the British National Health Service, report their findings in the journal Brain


The study investigated 52 patients who had suffered brain or spinal injury and

were treated at a neuro-rehabilitation unit.

Patients undergoing neuro-rehabilitation are often given anticholinergics to

relieve pain, urinary incontinence and other conditions.

The researchers found that the average length of stay among the patients

they studied was longer for those with higher levels of anticholinergic

drug burden (ACB) in their system.

The analysis showed a direct correlation between changes in ACB and length of

hospital stay. Patients whose ACB scores on discharge were higher than on admission stayed

longer in hospital and patients whose ACB scores on discharge were lower spent less time in hospital on


However, the researchers point out their study was not designed to prove cause

and effect; it can only show there is a link.

Anticholinergic drugs can interfere with rehabilitation

Senior author Chris Fox, a professor of clinical psychiatry at Norwich Medical

School at UEA, says:

“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.”

He explains that while it is often necessary to treat common complications of brain

and spinal cord injuries with anticholinergic drugs, medication side effects such

as cognitive impairment can get in the way of patients being able to engage fully

in their rehabilitation, resulting in a longer hospital stay.

Co-author Dr. Ian Maidment, who lectures in clinical pharmacy at Aston’s School

of Life & Health Sciences, says their findings add to the evidence that, where

possible, anticholinergics should be avoided in a wide range of populations.

“Regular medication review by a nurse, doctor or pharmacist may be a way

of ensuring that medicines with anticholinergic effects are used

appropriately,” he suggests.

The study is important not just for clinical reasons but also because one of the

measures of hospital performance is length of stay, and there are financial

incentives for discharging patients as soon as is safe.

Prof. Fox concludes:

“Identifying factors which might adversely affect the length of a

patient’s stay can have important financial as well as quality of life


Therefore, he adds, the study’s findings may help improve wider efficiency of

health care by reducing the time patients spend in rehabilitation.

Earlier this year, Medical News Today also learned of a significant

link between high use of anticholinergic drugs and

increased risk of developing dementia and Alzheimer’s disease in older


Written by Catharine Paddock PhD

Copyright: Medical News Today

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