The use of certain common medications could delay the recovery of patients with a brain or spinal cord injury, says a research team at the University of East Anglia and other universities in the United Kingdom. The findings were published on August 9, 2015, in the journal Brain Injury.
Researchers examined medications with anticholinergic properties which are prescribed to up to one-half of older adults for conditions such as depression, insomnia, and bladder problems. Antocholinergics are known to have side effects such as dizziness, confusion, and temporary cognitive impairment, but researchers say this study was the first to look at the effects of antocholinergics on people with pre-existing brain and spinal injuries. Clinicians in neuro-rehabilitation units often prescribe medications with anti-cholinergic properties for a variety of symptoms from pain to urinary incontinence.
Researchers studied 52 patients who had acquired brain or spinal cord injuries at a neuro-rehabilitation unit. Patients who had higher levels of anticholinergic medications in their bodies had a longer average hospital stays.
The state of having higher levels of anticholinergic drugs in a body is known as the anticholinergic drug burden, or ACB. A higher ACB score in patients on discharge, when compared to levels on admission, were associated with longer hospital stays and patients with lower ACB scores had shorter hospital stays on average. The team cautioned, however, that the research was an observational study, which means that they cannot imply a cause-and-effect relationship between hospital stays and ACB scores.
“The findings suggest there may be a statistically significant relationship between ACB score and length of stay in a neuro-rehabilitation unit following traumatic brain or spinal cord injury,” said Dr Chris Fox, lead author on the paper and professor of Clinical Psychiatry at the Norwich Medical School at UEA. “While medications with ACB are often needed to treat common complications of brain or spinal cord injuries, cognitive impairment due to the medication may adversely affect a patient’s ability to engage in the rehabilitation process, potentially increasing their length of stay in hospital.”
Dr. Fox added that the pilot study demonstrates a need for larger studies to confirm the findings and investigate the long-term effects of commonly prescribed medications on patient recovery. “This work adds to the evidence that anticholinergics should be avoided in a wide-range of populations, when possible,” Dr Ian Maidment, Senior Lecturer in Clinical Pharmacy at Aston University said. “Regular medication review by a nurse, doctor or pharmacist may be a way of ensuring that medicines with anticholinergic effects are used appropriately.”