Drugs with anticholinergic properties: a potential risk factor for psychosis onset in Alzheimer's disease?
Psychosis in Alzheimer's disease is common and troublesome. The impact on the quality of life of both patients and caregivers is high and drug treatments raise concern in terms of both efficacy and safety. Therefore, identifying the risk factors that play an important role in the onset of psychosis is mandatory for the prevention of this clinical condition. From a biological point of view, drugs with anticholinergic properties are a reasonable cause of psychosis. Demented patients have been found to use a disproportionate amount of drugs with anticholinergic properties. On the other hand, new evidence suggests that the cholinergic system may be implicated not only with the onset of cognitive impairment, but even in the genesis of psychosis symptoms. This review focuses on biological and clinical data which suggest that anti-cholinergic drugs should be regarded as a potential risk factor for psychosis in Alzheimer's disease.
Cancelli
Iacopo
I
Santa Maria della Misericordia University Hospital, Department of Neurology, Udine, Italy.
Beltrame
Massimiliano
M
D'Anna
Lucio
L
Gigli
Gian Luigi
GL
Valente
Mariarosaria
M
D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003702:Delusions / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D011605:Psychoses, Substance-Induced / Q000209:etiology* / Q000503:physiopathology; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011877:Radionuclide Imaging; D016032:Randomized Controlled Trials as Topic; D011976:Receptors, Muscarinic / Q000172:deficiency / Q000187:drug effects / Q000502:physiology; D012307:Risk Factors; D055139:Sensory Gating / Q000187:drug effects / Q000502:physiology; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology
D018680:Cholinergic Antagonists; D011976:Receptors, Muscarinic