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Risk of abnormally slow heart rate twice as high in those taking drugs to slow Alzheimer's
Date:10/1/2009

events," Park-Wyllie says. "A careful clinical evaluation is required before and after initiating these drugs, and they should only be continued when there is a definite positive response."

The potential cardiovascular toxicity of these dementia drugs may be underappreciated by clinicians, Park-Wyllie adds. More than half of the patients who had been hospitalized with bradycardia resumed taking their cholinesterase inhibitor after being discharged.

"Our study provides evidence of the potential adverse effect of cholinesterase inhibitors on heart rate. Health professionals need to reassess the merits of continued therapy in patients who develop bradycardia while taking these drugs," she says.

About cholinesterase inhibitors and dementia

Cholinesterase inhibitors are commonly prescribed to delay the progression of symptoms such as confusion and long-term memory loss in people with mild to moderate Alzheimer's disease.

It's known that people with dementia tend to have lower levels of a brain chemical called acetylcholine; the drugs work by boosting these levels. Reported side effectsincluding diarrhea, muscle cramps and abnormally slow heartbeatmay be related to increasing levels of acetylcholine in the body.

The benefits of cholinesterase inhibitors for people with Alzheimer's disease are generally small. The drugs do not reverse the effects of dementia. Other research suggests that in about half of patients, the drugs delay the worsening of symptoms for between six months to a year, although a minority of patients may benefit more.


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Contact: Julie Saccone
sacconej@smh.toronto.on.ca
416-864-5047
St. Michael's Hospital
Source:Eurekalert

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