Long-term use may increase the risk of both cognitive and physical decline. It is unclear whether they affect the risk of death generally. However, in older adults they do appear to increase the risk of death. Possible effects of<unk> s include: * Poor coordination * Dementia * Decreased mucus production in the nose and throat; consequent dry, sore throat * Dry-mouth with possible acceleration of dental caries * Cessation of sweating; consequent decreased epidermal thermal dissipation leading to warm, blotchy, or red skin * Increased body temperature * Pupil dilation; consequent sensitivity to bright light (photophobia) * Loss of accommodation (loss of focusing ability, blurred vision – cycloplegia) * Double-vision * Increased heart rate * Tendency to be easily startled * Urinary retention * Urinary incontinence while sleeping * Diminished bowel movement, sometimes ileus (decreases motility via the vagus nerve) * Increased intraocular pressure; dangerous for people with narrow-angle glaucoma. Possible effects in the central nervous system resemble those associated with delirium, and may include: * Confusion * Disorientation * Agitation * Euphoria or dysphoria * Respiratory depression * Memory problems * Inability to concentrate * Wandering thoughts; inability to sustain a train of thought * Incoherent speech * Irritability * Mental confusion (brain fog) * Wakeful myoclonic jerking * Unusual sensitivity to sudden sounds * Illogical thinking * Photophobia * Visual disturbances * Periodic flashes of light * Periodic changes in visual field *Visual snow * Restricted or "tunnel vision" * Visual, auditory, or other sensory hallucinations * Warping or waving of surfaces and edges * Textured surfaces * "Dancing" lines; "spiders", insects; form constants * Lifelike objects indistinguishable from reality * Phantom smoking * Hallucinated presence of people not actually there * Rarely: seizures, coma, and death * Orthostatic hypotension (severe drop in systolic blood pressure when standing up suddenly) and significantly increased risk of falls in the elderly population. Older patients are at a higher risk of experiencing CNS side effects. Toxicity An acute<unk>  syndrome is reversible and subsides once all of the causative agents have been excreted. Reversible acetylcholinesterase inhibitor agents such as physostigmine can be used as an antidote in life-threatening cases. Wider use is discouraged due to the significant side effects related to cholinergic excess including seizures, muscle weakness, bradycardia, bronchoconstriction, lacrimation, salivation, bronchorrhea, vomiting, and diarrhea. Even in documented cases of<unk>  toxicity, seizures have been reported after the rapid administration of physostigmine. Asystole has occurred after physostigmine administration for tricyclic antidepressant overdose, so a conduction delay (QRS > 0.10 second) or suggestion of tricyclic antidepressant ingestion is generally considered a contraindication to physostigmine administration.
Anticholinergic
Muscle relaxant
Narcotic
Antidote
Abirritant
Anticoagulant
Anxiolytic
Anticonvulsant