title: Chronic exposure to anticholinergic medications adversely affects the course of Alzheimer disease.
abstract: OBJECTIVE
  Authors examined the effect of chronic exposure to anticholinergics in a cohort of Alzheimer disease (AD) patients.
  
  
  METHODS
  All patients were examined annually with standard neuropsychologic tests and received the cholinesterase inhibitor donepezil hydrochloride at a dose of 10 mg/day. The study population (N=69) was divided into two groups: those receiving one or more concomitant medications with significant anticholinergic properties (N=16) and those receiving no concomitant medications with anticholinergic properties (N=53).
  
  
  RESULTS
  At 2 years, MMSE scores were significantly worse for patients receiving anticholinergic medications than for those not on anticholinergics.
  
  
  CONCLUSIONS
  Although very preliminary, these data suggest that concomitant therapy with anticholinergics may be associated with significant deleterious effects on acetylcholinesterase therapy, or, more speculatively, that chronic exposure to anticholinergics may have adverse effects on the clinical course of AD.
authors.affiliation: Department of Psychiatry at Wesley Woods Geriatric Teaching and Research Hospital, Emory University School of Medicine, Atlanta, Georgia 30329-5102, USA.
authors.forename: Ching-ju
authors.initials: CJ
authors.lastname: Lu
authors.forename: Larry E
authors.initials: LE
authors.lastname: Tune
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077265:Donepezil; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007189:Indans / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil