Prejudices in pharmacology and pharmacotherapy. The so-called anticholinergic effect of antidepressants

Abstract

Imipramine and similarly acting compounds provoke a number of undesired reactions usually classified as so-called anticholinergic effects. Instances of dry mouth, disturbance of micturition and tachycardia are regularly quoted in the literature. It is contended that these effects are not necessarily due to inhibition of the vagal system, but preferentially attributable to increased activity of the sympathetic system, predominantly mediated by the beta- or the alpha-adrenergic receptors, depending on the organ affected. This hypothesis is not only theoretically interesting, but also of practical clinical significance with regard to possible remedies.