Seizures in patients receiving concomitant antimuscarinics and acetylcholinesterase inhibitor.
Seizures occurred in two patients with probable Alzheimer's disease who were receiving long-term treatment with metrifonate, an irreversible acetylcholinesterase inhibitor. In both patients seizures were associated with discontinuation of short-term agents with high antimuscarinic properties. Hence, abrupt discontinuation of antimuscarinics or anticholinergics with high antimuscarinic properties in patients receiving long-term acetylcholinesterase inhibition therapy may be associated with a reduction of seizure threshold. With increasing administration of acetylcholinesterase inhibitors for patients with Alzheimer's disease, practitioners should be aware of the potential for drug-drug interactions and other complications. In general, it is good medical practice to avoid concomitant administration with centrally acting anticholinergic agents.
Piecoro
L T
LT
Drug Product Evaluation Unit, College of Pharmacy, University of Kentucky, Lexington, USA.
Wermeling
D P
DP
Schmitt
F A
FA
Ashford
J W
JW
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy; D001285:Atropine / Q000009:adverse effects*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D004316:Doxepin / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced*; D014236:Trichlorfon / Q000009:adverse effects* / Q000627:therapeutic use
D002800:Cholinesterase Inhibitors; D018727:Muscarinic Antagonists; D004316:Doxepin; D001285:Atropine; D014236:Trichlorfon