What is Dicyclomine?
Dicyclomine, or dicyclomine hydrochloride, is primarily employed in treating bowel disorders, including irritable bowel syndrome (IBS). It eases spasms in the gastrointestinal tract, relieving cramps and pain [1]. Commonly branded as Bentyl, it can be taken orally or by injection [2]. Safe for infants and children over 6 months, it is used to treat colic [3].
Belonging to the anticholinergic drug class, dicyclomine blocks acetylcholine's function at the acetylcholine ‘muscarinic’ receptor, enhancing the parasympathetic ‘rest and digest’ system. This relaxes smooth muscles in the stomach and intestines in the gastrointestinal tract, relieving spasms and cramps associated with colic and IBS [1]. The observed muscle relaxation throughout the body suggests dicyclomine's potential for anxiety treatment [4].
What is Anxiety?
Anxiety is a common and debilitating mental health condition characterized by future-oriented fear and negative appraisal of threatening situations. This results in stimulation of the ‘fight or flight’ response, including muscle tensing, hypervigilance or avoidance of situations that are perceived to be threatening.
Anxiety encompasses phobias, social anxiety disorder and generalized anxiety disorder and has an estimated annual prevalence of 12% [5]. Due to the high prevalence of anxiety and the diversity of symptoms, new anxiolytic drugs are being investigated.
While the causes of anxiety vary, in recent years, researchers have proposed that disturbances in the gut microbiome may cause anxiety.
Can Dicyclomine be used for Anxiety?
Dicyclomine is not currently used for anxiety treatment.
However, the neurobiology of dicyclomine intrigues researchers seeking anxiety treatments. Acting as an anticholinergic drug, it blocks acetylcholine effects throughout the body and brain. Increased acetylcholine activity, notably in the basal ganglia, such as the amygdala [6, 7], promotes anxiety behaviours. Therefore, reducing acetylcholine activity in these regions could alleviate anxiety symptoms, reducing physical spasms and racing thoughts. Blocking acetylcholine connections between the front of the brain and the amygdala effectively reduced anxiety after exposure to threatening stimuli, indicating a potential neurobiological mechanism for using dicyclomine in anxiety treatment [6].
Despite the promising effects on anxiety symptoms, dicyclomine is not utilized for anxiety due to the incomplete understanding of its exact mechanism in blocking acetylcholine and the availability of more effective treatments with fewer side effects.
What treatments are used for Anxiety?
Primary anxiety treatments involve tranquillizers that boost the inhibitory GABA neurotransmitter in the brain, inducing a calming effect. Common benzodiazepines like Xanax (alprazolam) or Valium (diazepam) are employed. Serotonin-targeting drugs are also used, including Buspirone, selective serotonin reuptake inhibitors, or serotonin-noradrenaline reuptake inhibitors [8]. Cognitive Behavioral Therapy (CBT) is a long-term effective strategy for managing anxiety [9].
What is Dicyclomine used for?
Aside from gastrointestinal relief, dicyclomine has demonstrated benefits in:
- Antimicrobial properties: Dicyclomine can inhibit bacterial and viral growth, aiding in microbial infection treatment [10, 11, 12]. Combined with antimicrobial treatments, dicyclomine may enhance outcomes in these conditions [12].
- Parkinson’s Disease: Anticholinergic drugs like dicyclomine may address cognitive and motor symptoms, such as memory loss and akinesia, associated with Parkinson’s Disease [13].
- Traumatic Brain Injury: Dicyclomine shows potential in improving functional outcomes post-traumatic brain injury, although more research is needed to confirm its safety and effectiveness [14].
What are the Side Effects of Taking Dicyclomine?
Dicyclomine may cause various side effects due to its targeting of acetylcholine receptors found throughout the body.
Common side effects include dry mouth, dizziness, blurry vision, nausea, sleepiness, weakness, and nervousness. It's crucial to consult your doctor if these effects interfere with daily activities [1].
Serious side effects requiring immediate medical attention include abnormal or rapid heart rate, eye problems like blurry vision, difficulty moving your eyes, and increased sensitivity to light. Although uncommon, allergic reactions may occur, with symptoms like swelling of your face, tongue, throat, arms, and legs, difficulty breathing or swallowing, and skin rash, welts, or hives [1]. Always inform your doctor of all allergies to tailor prescriptions accordingly.
Do not take dicyclomine without a prescription.
In summary, dicyclomine is not recommended for anxiety treatment despite its potential. While there is preliminary evidence of anticholinergic drugs improving the perception of threatening stimuli in anxiety, specific and controlled modulation of these brain pathways is required. Seek medical attention if you find that dicyclomine used for gastrointestinal symptoms is increasing your anxiety.