[Cholinesterase inhibitors in dementia: the precarious balance between efficacy and safety].
Cholinesterase inhibitors are widely prescribed in patients with Alzheimer's disease. Recently it has become clear that using these medications increases the risk of serious adverse events like cardiac arrhythmias, and some studies report a much-increased mortality in the treatment group on comparison with the placebo group. In the light of the at best, modest, treatment effects, we advocate that the safety of cholinesterase inhibitors should be the subject of continuing, intense scrutiny. Efforts should be made to delineate the profile of a true 'cholinergic deficiency syndrome', in order to be able to prescribe these medications to a group of patients in whom the benefits outweigh the risks.
Richard
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E
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Neurologie, Meibergdreef 9, 1105 AZ Amsterdam.
van Gool
W A
WA
D000544:Alzheimer Disease / Q000188:drug therapy*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors