Table II.
Commonly prescribed anticholinergic drugs associated with dry mouth
| Medication (frequency of usage) | Xerostomia risk | Muscarinic receptor antagonism (Ki)* |
|---|---|---|
| Selective serotonin reuptake inhibitors (22%) | ||
| Paroxetine | 1.98 | 72.0 |
| Escitalopram | 2.19 | 1240.0 |
| Sertraline | 1.48 | 1300.0 |
| Fluoxetine | 1.64 | 2000.0 |
| Citalopram | 2.01 | 2200.0 |
| Serotonin-norepinephrine reuptake inhibitors (11%) | ||
| Duloxetine | 6.02 | 3000.0 |
| Venlafaxine | 2.67 | >10,000.0 |
| Antidepressant agents (50%) | ||
| Mirtazapine | 1.42 | 800.0 |
| Vilazodone | 1.50 | 28,000.0 |
| Bupropion | 2.00 | 48,000.0 |
| Trazodone | 1.51 | 324,000.0 |
| Tricyclic antidepressants (27%) | ||
| Dothiepin | 25.0 | |
| Amitriptyline | 3.28 | 25.9 |
| Nortriptyline | 50.0 | |
| Doxepin | 2.91 | 52.0 |
| Imipramine | 3.81 | 102.0 |
| Antipsychotics | ||
| Olanzapine | 13.0 | |
| Chlorpromazine | 4.00 | 67.0 |
| Quetiapine | 2.42 | 1320.0 |
| Risperidone | >10,000.0 | |
| Overactive bladder medications (30%) | ||
| Trospium | 0.8 | |
| Darifenacin | 7.41 | 0.8 |
| Tolterodine | 4.82 | 3.4 |
| Oxybutynin | 18.85 | 11.2 |
| Fesoterodine | 6.94 | 26.9 |
| Solifenacin | 5.34 | 64.3 |
| Asthma (20%) | ||
| Tiotropium | 0.2 | |
| Ipratropium | 0.5 | |
| Muscle control | ||
| Biperiden | 3.9 | |
| Cyclobenzaprine | 6.0 | |
Medications are reported by indication and frequency and further ranked by their muscarinic anticholinergic potency: Lower values of Ki denote higher potency. Available xerostomia risk is reported by relative risk ratio. (Relative risk ratio based on published data35,44,46,65–67; Ki extracted from the Psychoactive Drug Screening Program database.)
Ki, muscarinic receptor inhibitor constant.