Which antidepressant is listed as having strong anticholinergic properties?

• A. Amitriptyline
• B. Sertraline
• C. Fluoxetine
• D. Venlafaxine

Answer: (A)

Anticholinergic effects come from blocking muscarinic acetylcholine receptors. Among antidepressants, tricyclics like amitriptyline have strong muscarinic receptor antagonism because of their chemical structure, so they produce prominent anticholinergic side effects such as dry mouth, constipation, urinary retention, blurred vision, and confusion—especially in older adults.

The other options—sertraline and fluoxetine (both SSRIs) and venlafaxine (an SNRI)—primarily affect serotonin and/or norepinephrine reuptake and do not strongly block muscarinic receptors, so their anticholinergic properties are minimal. At very high doses venlafaxine can have some anticholinergic effects, but not to the degree seen with amitriptyline.

Thus amitriptyline is the antidepressant with the strongest anticholinergic properties.