Exploratory pilot study assessing the risk of cognitive impairment or sedation in the elderly following single doses of solifenacin 10 mg

Wesnes, Keith; Edgar, Chris J.; Tretter, Reiner; Bolodeoku, John

doi:10.1517/14740330903260790

Cited by 77 publications

(43 citation statements)

References 28 publications

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“…The first, a crossover study in 12 cognitively intact older adults, examined the effect of a single dose of solifenacin 10 mg using placebo and oxybutynin 10 mg immediate release and found no evidence for an effect of solifenacin versus placebo at the time of its maximum serum concentration (C max ). Oxybutynin was associated with statistically significant impairments versus placebo [75]. In a chronic-dosing, three-way crossover study of solifenacin 5 mg, placebo, and oxybutynin immediate-release 5 mg twice daily in 24 healthy volunteers with mild cognitive impairment, no discernible effect of either solifenacin or oxybutynin versus placebo could be detected at similar time points.…”

Section: Bladder Antimuscarinics and Cognitionmentioning

confidence: 92%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual's situation should be applied.

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Section: Bladder Antimuscarinics and Cognitionmentioning

confidence: 92%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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“…Results of a large observational study with an all-male cohort (mean age 67 years) taking solifenacin for relief of OAB symptoms also reported no change in cognitive function after 12 weeks using the MMSE [30] . Using a more sensitive tool for assessing cognitive function, 2 separate studies found no evidence of impairment in cognitive function in healthy elderly volunteers [31] and similar effects to placebo in cognitive outcomes in elderly volunteers with mild cogni- Hampel [34] . These variables were not controlled for or evaluated in our study but could provide valuable information if considered in future studies.…”

Section: Discussionmentioning

confidence: 99%

Solifenacin in the Elderly: Results of an Observational Study Measuring Efficacy, Tolerability and Cognitive Effects

Hampel

Betz

Burger³

et al. 2017

Urol Int

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Introduction: The study aimed to evaluate the efficacy and safety of solifenacin in older patients with overactive bladder (OAB). Materials and Methods: Observational data on patients aged ≥70 years and the prescribed flexible dose of solifenacin for OAB were collected at 294 offices of German general practitioners. Baseline and week 12 data included type and severity of OAB symptoms, adverse events, quality of life, and change in cognitive function per Mini Mental State Examination (MMSE). Results: Mean age of 774 patients was 78 ± 6 years. A decrease was observed in all OAB symptoms including a reduction of urinary urgency and micturition, each by 4 episodes per 24 h. No change in mean MMSE scores was apparent at week 12. Adverse events and treatment discontinuations were low at 5.8 and 0.5%, respectively. Conclusion: Solifenacin was well-tolerated while OAB symptoms declined at week 12. No relevant effect of solifenacin on cognitive function was observed in this elderly population.

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“…The risk for these agents to impair cognitive functioning is related to their ability to penetrate the brain and their interaction with muscarinic M1 receptors [ 143 ] . In a study of healthy elderly volunteers, solifenacin did not seem to affect cognition, whereas oxybutynin impaired several measures of cognition [ 144 ] . After 3 weeks of treatment, healthy elderly subjects experienced signi fi cant memory impairment on oxybutynin in contrast to those on darifenacin, which showed no difference in memory compared to the placebo group [ 145 ] .…”

Section: Urinary Antispasmodicsmentioning

confidence: 90%

Medications and Cognition in Older Adults

Caporaso¹

2012

Handbook on the Neuropsychology of Aging and Dementia

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The elderly patient is particularly susceptible to negative effects on cognition that can arise from certain medications. This may occur whether or not pre-existing cognitive impairment is present. Medications whose primary target is the central nervous system (e.g., antidepressants, antipsychotics, sedative-hypnotics) or those which are targeted at other primary systems (e.g., cardiovascular drugs, urinary anti-spasmodics) should be considered as contributing factors in the patient with confusion or memory decline. Steps that can be taken to reduce this risk include: coordination of medical care among the patient's clinicians to avoid polypharmacy, judicious selection of appropriate medications, use of the lowest effective drug dose, and substitution of non-pharmacologic therapies whenever possible. This chapter addresses potential complications of medication use in older adults with cognitive decline.

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Exploratory pilot study assessing the risk of cognitive impairment or sedation in the elderly following single doses of solifenacin 10 mg

Abstract: In this pilot study, single 10 mg doses of solifenacin did not show any clear propensity to impair cognitive function in a healthy elderly population.

Cited by 77 publications

References 28 publications

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Solifenacin in the Elderly: Results of an Observational Study Measuring Efficacy, Tolerability and Cognitive Effects

Medications and Cognition in Older Adults

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