OBJECTIVES: Co-prescription of anticholinergic drugs with the traditional cholinesterase inhibitors treatment in patients suffering from Alzheimer’s disease (AD) is not recommended.  Yet the extent of anticholinergic drugs use is unknown. Conversely, the prescription of anticholinergic drugs is not contraindicated with the N-Methyl-D-Aspartic acid (NMDA) receptor antagonist. This study evaluates the pattern of usage of drugs with anticholinergic activity in geriatric patients with AD receiving cholinesterase inhibitors and NMDA receptor antagonist. METHODS: 654 patients suffering from AD above the age of 65 years were analyzed from NNHS 2004. The co-prescribed anticholinergic drugs were given a score of 0 to 3 using the Clinician-Rated Anticholinergic Drug Scale with values ranging from no, mild, moderate and high anticholinergic activity respectively. Frequency of the use of drugs having anticholinergic activity prescribed along with cholinesterase inhibitors and NMDA receptor antagonist was compared using the Chi square test. RESULTS: Of the patients with AD, 654 patients were given cholinesterase inhibitors and NMDA receptor antagonist. Most of the AD patients were prescribed with cholinesterase inhibitors (86.69%) as compared to NMDA receptor antagonist (14.83%). 98.94% of patients on cholinesterase inhibitors and 93.82% on NMDA receptor antagonist were co-prescribed drugs with anticholinergic properties. Similar percent of patients on cholinesterase inhibitors and NMDA receptor antagonist were co-prescribed drugs with mild (65.43% vs 63.92%, p=0.7723), moderate (22.40% vs 21.65%, p=0.8699) and high (11.11% vs 8.25%, p=0.3990) anticholinergic activity. No statistical difference in prescribing moderate to high anticholinergic agents for treating Depression, Convulsions and Parkinson’s disease was found in AD patients being treated with cholinesterase inhibitors and NMDA receptor antagonist. CONCLUSIONS: Patients with AD receiving cholinesterase inhibitors or NMDA receptor antagonist appear to be co-prescribed drugs having moderate and high level of anticholinergic activity without any distinction. Physicians should be more prudent in co-prescribing drugs with anticholinergic activity in patients with AD due to the high risk of adverse reactions.