Drugs with ACB Score of 1 Drugs with ACB Score of 2 Drugs with ACB Score of 3

Generic Name Brand Name Generic Name Brand Name Generic Name Brand Name
Alimemazine Theralen Amantadine Symmetrel Amitriptyline Elavil
Alverine Spasmonal Belladonna Multiple Amoxapine Asendin
Alprazolam Xanax Carbamazepine Tegretol Atropine Sal-Tropine
Aripiprazole Abilify Cyclobenzaprine Flexeril Benztropine Cogentin
Asenapine Saphris Brompheniramine Dimetapp
Cyproheptadine Periactin
Atenolol Tenormin Carbinoxamine Histex, Carbihist
Loxapine Loxitane
Bupropion Wellbutrin, Zyban Chlorpheniramine Chlor-Trimeton
Meperidine Demerol
Captopril Capoten Chlorpromazine Thorazine
Methotrimeprazine Levoprome Clemastine Tavist
Cetirizine Zyrtec
Chlorthalidone Diuril, Hygroton Molindone Moban Clomipramine Anafranil
Cimetidine Tagamet Nefopam Nefogesic Clozapine Clozaril
Clidinium Librax Oxcarbazepine Trileptal Darifenacin Enablex
Clorazepate Tranxene Pimozide Orap Desipramine Norpramin
Codeine Contin Dicyclomine Bentyl
Colchicine Colcrys Dimenhydrinate Dramamine, others
Desloratadine Clarinex Categorical Scoring: Diphenhydramine Benadryl, others
Diazepam Valium Possible anticholinergics include those listed with a Doxepin Sinequan
Digoxin Lanoxin score of 1; Definite anticholinergics include those Doxylamine Unisom, others
Dipyridamole Persantine listed with a score of 2 or 3 Fesoterodine Toviaz
Disopyramide Norpace Flavoxate Urispas
Fentanyl Duragesic, Actiq Numerical Scoring: Hydroxyzine Atarax, Vistaril
Furosemide Lasix Add the score contributed to each selected medication Hyoscyamine Anaspaz, Levsin
Fluvoxamine Luvox in each scoring category Imipramine Tofranil
Haloperidol Haldol Meclizine Antivert
Add the number of possible or definite Anticholinergic
Hydralazine Apresoline Methocarbamol Robaxin
medications
Hydrocortisone Cortef, Cortaid Nortriptyline Pamelor
Iloperidone Fanapt Olanzapine Zyprexa
Isosorbide Isordil, Ismo Orphenadrine Norflex
Levocetirizine Xyzal
Notes: Oxybutynin Ditropan
Loperamide Immodium, others
Each definite anticholinergic may increase the risk of Paroxetine Paxil
Loratadine Claritin cognitive impairment by 46% over 6 years. 3 Perphenazine Trilafon
Metoprolol Lopressor, Toprol For each on point increase in the ACB total score, a Promethazine Phenergan
Morphine MS Contin, Avinza decline in MMSE score of 0.33 points over 2 years has Propantheline Pro-Banthine
Nifedipine Procardia, Adalat been suggested. 4 Propiverine Detrunorm
Paliperidone Invega Additionally, each one point increase in the ACB total Quetiapine Seroquel
Prednisone Deltasone, Sterapred score has been correlated with a 26% increase in the Scopolamine Transderm Scop
Quinidine Quinaglute risk of death. 4 Solifenacin Vesicare
Ranitidine Zantac Thioridazine Mellaril
Risperidone Risperdal Tolterodine Detrol
Theophylline Theodur, Uniphyl Trifluoperazine Stelazine
Trazodone
Triamterene
Desyrel
Dyrenium
Aging Brain Care Trihexyphenidyl
Trimipramine
Artane
Surmontil
Venlafaxine Effexor Trospium Sanctura
Warfarin Coumadin www.agingbraincare.org
 Medications Reviewed in 2012 Update Complete References: Aging Brain Care
Medications Added with Medications Added with
1. Boustani MA, Campbell NL, Munger S, Maidment I, Fox
Score of 1: Score of 2:
GC. Impact of anticholinergics on the aging brain: a review
Aripiprazole (Abilify) Nefopam (Nefogesic) and practical application. Aging Heatlh. 2008;4(3):311-320.
Asenapine (Saphris)
Cetirizine (Zyrtec) Medications Added with 2. Campbell N, Boustani M, Limbil T, et al. The cognitive
ANTICHOLINERGIC
Clidinium (Librax)
Desloratadine (Clarinex)
Score of 3:
Doxylamine (Unisom,
impact of anticholinergics: a clinical review.
Clinical Interventions in Aging. 2009;4(1):225-233.
COGNITIVE BURDEN
Iloperidone (Fanapt)
Levocetirizine (Xyzal)
others)
Fesoterodine (Toviaz)
3. Campbell N, Boustani M, Lane K, et al. Use of anticholinergics SCALE
and the risk of cognitive impairment in an African-
Loratadine (Claritin) Propiverine (Detrunorm) American population. Neurology. 2010;75:152-159.
Paliperidone (Invega) Solifenacin (Vesicare)
Venlafaxine (Effexor) Trospium (Sanctura) 4. Fox C, Richardson K, Maidment I, et al. Anticholinergic
medication use and cognitive impairment in the
older population: the Medical Research Council
Medications Reviewed But NOT Added: Cognitive Function and Ageing Study. Journal of the
Fexofenadine (Allegra)
Gabapentin (Neurontin)
American Geriatric Society. 2011; 59(8): 1477-1483.
2012 Update
5. Cai X, Campbell N, Khan B, Callahan C, Boustani M.
Topiramate (Topamax) Long-term anticholinergic use and the aging brain.
Levetiracetam (Keppra) Alzheimers Dementia. 2012; epub ahead of print. Developed by the Aging Brain Program
Tamoxifen (Nolvadex) of the Indiana University Center for
Nizatidine (Axid) Aging Research
Duloxetine (Cymbalta)

Criteria for Categorization:

Score of 1: Evidence from in vitro data that chemical
entity has antagonist activity at muscarinic receptor. Copyright 2008, 2012. Regenstrief Institute, Inc. All rights reserved.

Score of 2: Evidence from literature, prescribers
information, or expert opinion of clinical anticholinergic
effect.
Score of 3: Evidence from literature, expert opinion,
or prescribers information that medication may cause
delirium.
Use of the Anti-Cholinergic Burden (ACB) Scale may only be
in accordance with the Terms of Use for the ACB Scale which
are available at http://www.agingbraincare.org/tools/abc-
anticholinergic-cognitive-burden-scale.
To request permission for use, contact us at
acb@agingbraincare.org.