Tolterodine and memory: dry but forgetful.
BACKGROUND
Anticholinergic drugs are known to produce or enhance cognitive deficits. Tolterodine tartrate is marketed as a bladder-selective anticholinergic drug that is reported to be free of significant cognitive adverse effects.


OBJECTIVE
To describe a 46-year-old woman who had memory loss and abnormal memory test results that improved when she discontinued tolterodine therapy.


RESULTS
While taking tolterodine, the patient's score on the delayed free recall portion of the Hopkins Verbal Learning Test-Revised was at the first percentile. One month after discontinuing tolterodine therapy, this test was administered a second time using an alternative form and she showed marked improvement scoring above the 75th percentile.


CONCLUSIONS
Tolterodine therapy caused cognitive dysfunction in our patient. It is possible that cognitive dysfunction is a common result of tolterodine treatment, but in the absence of testing, remains undiagnosed. Alternatively, our patient may have had aberrant metabolism of this drug or an increased sensitivity as a result of incipient Alzheimer disease.
Womack
Kyle B
KB
Department of Neurology, University of Florida College of Medicine, and the Neurology Service, Department of Veterans Affairs Medical Center, Gainesville, USA. kyle.womack@utsouthwestern.edu
Heilman
Kenneth M
KM
D001559:Benzhydryl Compounds / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced; D003408:Cresols / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008569:Memory Disorders / Q000139:chemically induced*; D011939:Mental Recall / Q000187:drug effects; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; D014555:Urination Disorders / Q000188:drug therapy*
D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate