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.
Drug Product Evaluation Unit, College of Pharmacy, University of Kentucky, Lexington, USA.
L T
LT
Piecoro
D P
DP
Wermeling
F A
FA
Schmitt
J W
JW
Ashford
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