Less is More: Reducing the Anticholinergic Medication Burden in Patients receiving Antipsychotics

This training is designed to address anticholinergic medications such as benztropine (Cogentin) or trihexyphenidyl (Artane) are often used in psychiatry to mitigate extrapyramidal side effects associated with antipsychotic medications. However, anticholinergic medications themselves have troublesome side effects including dry mouth, blurred vision, constipation, urinary retention and cognitive memory deficits, all of which can significantly impact patient quality of life. In clinical practice, anticholinergic medications for EPS are often refilled and continued for years or indefinitely. However, WHO recommendations and expert consensus suggests that anticholinergic medications could be safely tapered and discontinued within a few months if no longer needed.

Target Audience

This course is designed for health care professionals including physicians, other prescribers, pharmacists, nurses, patients and caregivers, among others.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Define extrapyramidal symptoms and what medications are used to treat them.
  • Identify the side effects associated with anticholinergic medications, including peripheral and central effects.
  • Describe how reducing anticholinergic medications for EPS can improve clinical outcomes and quality of life in patients on antipsychotics.
  • Discuss predictors and barriers of success to deprescribing anticholinergic medications in psychiatric practice.

Disclaimer Statement:

The information presented at this activity represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine.  Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.

Course summary
Available credit: 
  • 1.00 ACPE Pharmacy
    The UPMC Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education.
  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
02/10/2023
Course expires: 
02/10/2026

Planning Committee:

Joan Spinogatti - Administrative Coordinator, CRS, Office of the Service Line Chief - CRS, UPMC Western Psychiatric Hospital

Course Directors:

  • K.N. Roy Chengappa, MD, MRCPsych - Professor of Psychiatry, University of Pittsburgh School of Medicine; Chief, Comprehensive Service Line; UPMC Western Psychiatric Hospital  
  • Jessica M. Gannon, MD - Medical Director of WPIC Ambulatory eRecord; Medical Director of the CRS Ambulatory Clinics; CRS Director of Education and Training; Associate Professor, University of Pittsburgh School of Medicine; Attending Psychiatrist, Western Psychiatric Hospital UPMC
  • Ana M. Lupu, PharmD - Adjunct Instructor of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy; Clinical Pharmacist, Forbes Pharmacy; UPMC Western Psychiatric Hospital

Conflict of Interest Disclosure:
No planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME) and the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician (CME)
The University of Pittsburgh designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit[s]™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacy (CPE)
This knowledge-based activity provides 1.0 contact hours of continuing pharmacy education credit.

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Available Credit

  • 1.00 ACPE Pharmacy
    The UPMC Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education.
  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 Attendance
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