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Many Alzheimer's patients get drugs with opposing effects
Date:10/25/2011

SEATTLE, WAYou wouldn't brake your car while stepping on the gasor wash down a sleeping pill with espresso. Yet many people taking common Alzheimer's disease medicationscholinesterase inhibitorsare given medications with anticholinergic properties, which oppose their effects. Group Health Research Institute scientists investigated how often that happens and reported on the consequences in an "Early View" study e-published in the Journal of the American Geriatrics Society.

"Cholinesterase inhibitors are today's primary therapy for slowing Alzheimer's disease," said study leader Denise Boudreau, PhD, RPh, an associate scientific investigator at Group Health Research Institute. "Anticholinergic properties are often found in drugs commonly used to treat gastrointestinal disorders, allergies, urinary incontinence, depression, and Parkinson's disease, and they can have negative effects on cognition and function in the elderly. There's concern that if someone is taking both types of drugscholinesterase inhibitors and anticholinergic medicationsthey will antagonize each other, and neither will work."

In clinical trials, cholinesterase inhibitors show modest effects against the functional and cognitive decline of people with Alzheimer's disease. These medications, such as donepezil (Aricept) work by inhibiting the breakdown of acetylcholine, which sends signals in the nervous system. By contrast, anticholinergicssuch as diphenhydramine (Benadryl) and oxybutynin (Ditopan)block the action of acetylcholine. Since the two types of drugs have opposite effects, it makes sense not to give both kinds of drugs to an individual person. But until Dr. Boudreau's study, few researchers had explored how often patients are prescribed both types of medications and which harms this might cause.

Dr. Boudreau and colleagues conducted a retrospective cohort study of 5,625 people aged 50 or older who received a new prescription for cholinesterase inhi
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Contact: Rebecca Hughes
hughes.r@ghc.org
206-287-2055
Group Health Research Institute
Source:Eurekalert  

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