Anticholinergic cognitive burden scale
This scale was developed Dr. Malaz Boustani, a researcher at the Regenstrief Institute and the Indiana University Center for Aging Research, and her colleagues.
A drug was given a score of 1 if it had possible anticholinergic effects based on lab tests but no evidence of clinically relevant cognitive effects A drug was given a score of 2 or 3 if it had established and clinically relevant anticholinergic effects. Drugs not listed have a score of 0.
The idea is to add up the scores of the drugs a person is taking. If the sum of the scores is 3 or more, then medications with lower anticholinergic cognitive burden scores might be considered to lower the overall anticholinergic cognitive burden.
The drugs are listed in alphabetical order with the generic name listed first, followed by notable brand names.
SCORE 1
alprazolam (Xanax)
atenolol (Tenormin)
brompheniramine maleate (Veltane)
bupropion hydrochloride (Wellbutrin, Zyban)
captopril (Capoten)
chlorthalidone (Thalitone)
cimetidine hydrochloride (Tagamet)
clorazepate (Tranxene)
codeine
colchicine (Colcrys)
diazepam (Valium)
digoxin (Lanoxin)
dipyridamole (Persantine)
disopyramide phosphate (Norpace)
fentanyl
isosorbide (Ismotic)
loperamide (Imodium)
metoprolol (Lopressor, Toprol-X)
morphine
nifedipine (Adalat, Procardia)
prednisone
quinidine (Duraquin, Quinora)
risperidone (Risperdal)
theophylline (many brands)
trazodone (Desyrel, Trialodine)
triamterene (Dyrenium)
SCORE 2
amantadine (Symadine)
belladone alkaloids
carbamazepine (Carbatrol, Teril)
cyclobenzaprine (Amrix, Flexeril)
cyproheptadine (Periactin)
loxapine (Loxitane)
meperidine (Demerol)
methotrimeprazine (Levoprome, Nozinan)
molindone (Moban)
oxcarbazepine (Trileptal)
pimozide (Orap)
SCORE 3
amitriptyline (Elavil)
amoxapine (Asendin)
benztropine (Cogentin)
carbinoxamine (Clistin)
chlorpheniramine (an ingredient in many cough and cold medicines)
clemastine (Tavist)
clomipramine (Anafranil)
clozapine (Clozaril)
darifenacin (Enablex)
desipramine (Norpramine, Pertofrane)
dicyclomine (Bentyl)
dimenhydrinate
diphenhydramine (an ingredient in cough and cold medicines)
doxepin (Sinequan, Zonalon)
flavoxate (Urispas)
hydroxyzine (Atarax, Vistaril)
imipramine (Janimine, Tofranil)
meclizine (Antivert)
nortriptyline (Pamelor)
olanzapine (Zyprexa)
orphenadrine (Disipal, Norflex)
oxybutynin (Ditropan)
paroxetine (Paxil)
perphenazine (Trilafon)
procyclidine (Kemadrin)
promethazine (Phenergan, Zipan)
quetiapine (Seroquel)
Scopolamine
thioridazine (Mellaril)
tolterodine (Detrol)
trifluoperazine (Stelazine)
trihexyphenidyl (Artane, Tremin)
Trimipramine (Surmontil)
