Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer’s Disease

Fereshtehnejad, Seyed‐Mohammad; Johnell, Kristina; Eriksdotter, Maria

doi:10.1007/s40266-014-0154-8

Cited by 39 publications

(16 citation statements)

References 38 publications

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“…The occurrence of antipsychotic drug use in this study is in line with a previous Swedish study from 2001 that reported a prevalence of 18% among people with dementia and 2% among people without the disease , and similar results have also been found in Finland in 2005 . However, studies with more recent data from the Swedish Dementia Registry have reported a lower prevalence of 6% among people with dementia and 4% among people with Alzheimer's disease . The lower prevalence may reflect an earlier stage of disease in the Swedish Dementia Registry or an increasing awareness of cautious prescribing of these drugs.…”

Section: Discussionsupporting

confidence: 91%

Educational disparities in antipsychotic drug use among older people with and without dementia in Sweden

Wastesson

Weitoft

Johnell

2014

Acta Psychiatr Scand

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Section: Discussionsupporting

confidence: 91%

Educational disparities in antipsychotic drug use among older people with and without dementia in Sweden

Wastesson

Weitoft

Johnell

2014

Acta Psychiatr Scand

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“…Antipsychotics are probably prescribed for BPSD symptoms in the initial treatment period. AChEI use for BPSD in AD may be beneficial [31, 38], but the evidence is inconsistent [39]. Strong anticholinergic effects of antipsychotics may counteract the effect of AChEIs, and a QT interval prolongation and extrapyramidal side effects caused by pharmacodynamic interactions between AChEIs and antipsychotics may explain why so many patients using antipsychotics ended AChEI treatment after <1 year.…”

Section: Discussionmentioning

confidence: 99%

Comedication and Treatment Length in Users of Acetylcholinesterase Inhibitors

Efjestad

Ihle‐Hansen

Hjellvik

et al. 2017

Dement Geriatr Cogn Disord Extra

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Background/Aims: Reduced clinical effect on cognitive decline in dementia by acetylcholinesterase inhibitors (AChEIs) may be due to concurrent use of drugs with anticholinergic properties. The aim was to analyze the incidence of AChEI use and comedication with drugs with anticholinergic properties and other potential unfavorable effects. Methods: A prospective study applying drug use data from the Norwegian Prescription Database. Anticholinergic Drug Scale (ADS) scores were used as a measure of overall anticholinergic burden. Results: Patients with high ADS scores were more frequently discontinuing treatment early. Coprescribing of antipsychotics was strongly associated with early discontinuation of AChEI treatment. Conclusion: Coprescribing with potentially unfavorable medications was common. A high ADS score was associated with early discontinuation of treatment.

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“…The clinician is faced with many difficult decisions and little evidence to rely on. Thus, more research is needed on how to best treat patients with cognitive impairment and dementia across the different stages of disease [40]. …”

Section: Discussionmentioning

confidence: 99%

Inappropriate Drug Use in People with Cognitive Impairment and Dementia: A Systematic Review

Johnell

2015

CCP

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The aim of this systematic review was to identify, assess and summarize studies about potentially inappropriate drug use (IDU) in cognitive impairment and dementia and to present findings about whether cognitive impairment and dementia are associated with IDU. The search was made in Medline/PubMed using free terms in the title or abstract. The inclusion criteria were: English language, published until 1 March 2014, original quantitative study and assessment of overall IDU with a consensus based summarized measure. Exclusion criteria were: focus on specific patient group (other than cognitive impairment or dementia), focus on specific drug class and failure to present a prevalence measure of IDU or an effect estimate (i.e. odds ratio). Of the initial 182 studies found in Medline, 22 articles fulfilled the criteria. Most studies used the Beers criteria for assessment of IDU. Prevalence of IDU among individuals with cognitive impairment or dementia ranged from 10.2% to 56.4% and was higher in nursing home settings than in community-dwelling samples. Most studies reported a lower likelihood of IDU in case of cognitive impairment or dementia. To conclude, IDU is highly prevalent among persons with cognitive impairment and dementia, although these conditions seem to be associated with a lower probability of IDU. This might reflect an awareness among clinicians of cautious prescribing to this vulnerable group of patients. More studies on large cohorts of persons with cognitive impairment and dementia are needed to draw conclusions about optimal drug prescribing to this frail group of older persons.

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Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer’s Disease

Abstract: Patients taking ChEIs were treated with less antipsychotics and anxiolytics than those not taking ChEIs. More research is warranted to elucidate whether use of ChEIs in clinical practice can reduce the need for psychotropic drugs in AD patients.

Cited by 39 publications

References 38 publications

Educational disparities in antipsychotic drug use among older people with and without dementia in Sweden

Educational disparities in antipsychotic drug use among older people with and without dementia in Sweden

Comedication and Treatment Length in Users of Acetylcholinesterase Inhibitors

Inappropriate Drug Use in People with Cognitive Impairment and Dementia: A Systematic Review

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