Fatal Aspiration Pneumonia during Transition from Donepezil to Rivastigmine

Taylor, Amy; Anderson, Doris; Tobert, Daren G.

doi:10.1345/aph.1c036

Cited by 13 publications

(3 citation statements)

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“…A switch without washout of the previous drug is recommended mainly on theoretical grounds for galantamine (Maelicke, 2001;Wilkinson and Howe, 2005) and absence of side effects in two retrospective studies of switching from donepezil or rivastigmine to galantamine (Edwards et al, 2004a) and donepezil to rivastigmine (Sadowsky et al, 2005). There is one case report of a fatal adverse event during transition from donepezil to rivastigmine (Taylor et al, 2002). Efficacy of the switch has been evaluated in two published open-label studies: a retrospective study of 40 patients showing that half of those switching due to lack of efficacy benefited from the switch, although this benefit was not clearly defined (Bullock and Connolly, 2002).…”

Section: Switching and Combination Therapymentioning

confidence: 99%

Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology

2006

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The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review the evidence on the drug treatment for dementia. The level of evidence (types) was rated using a standard system: Types 1a and 1b (evidence from meta-analysis of randomised controlled trials or at least one controlled trial respectively); types 2a and 2b (one well-designed study or one other type of quasi experimental study respectively); type 3 (non-experimental descriptive studies); and type 4 (expert opinion). There is type 1a evidence for cholinesterase inhibitors (donepezil, rivastigmine and galantamine) for mild to moderate Alzheimer's disease; memantine for moderate to severe Alzheimer's disease; and for the use of bright light therapy and aromatherapy. There is type 1a evidence of no effect of anti inflammatory drugs or statins. There is conflicting evidence regarding oestrogens, with type 2a evidence of a protective effect of oestrogens but 1b evidence of a harmful effect. Type 1a evidence for any effect of B12 and folate will be forthcoming when current trials report. There is type 1b evidence for gingko biloba in producing a modest benefit of cognitive function; cholinesterase inhibitors for the treatment of people with Lewy body disease (particularly neuropsychiatric symptoms); cholinesterase inhibitors and memantine in treatment cognitive impairment associated with vascular dementia; and the effect of metal collating agents (although these should not be prescribed until more data on safety and efficacy are available). There is type 1b evidence to show that neither cholinesterase inhibitors nor vitamin E reduce the risk of developing Alzheimer's disease in people with mild cognitive impairment; and there is no evidence that there is any intervention that can prevent the onset of dementia. There is type 1b evidence for the beneficial effects of adding memantine to cholinesterase inhibitors, and type 2b evidence of positive switching outcomes from one cholinesterase inhibitor to another. There is type 2a evidence for a positive effect of reminiscence therapy, and type 2a evidence that cognitive training does not work. There is type 3 evidence to support the use of psychological interventions in dementia. There is type 2 evidence that a clinical diagnosis of dementia can be made accurately and that brain imaging increases that accuracy. Although the consensus statement dealt largely with medication, the role of dementia care in secondary services (geriatric medicine and old age psychiatry) and primary care, along with health economics, was discussed. There is ample evidence that there are effective treatments for people with dementia, and Alzheimer's disease in particular. Patients, their carers, and clinicians deserve to be optimistic in a field which often attracts therapeutic nihilism.

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Section: Switching and Combination Therapymentioning

confidence: 99%

Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology

2006

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“…The use of these drugs is associated with nausea and vomiting in a percentage between 5 and 31% in various trials. There is only 1 case report which correlates this effect to aspiration pneumonia [69]. Donepezil however seems to have an effect in reducing the entity of SDB [70].…”

Section: Introductionmentioning

confidence: 99%

Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician

Falsetti¹,

Viticchi²,

Zaccone³

et al. 2021

Med Princ Pract

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Chronic respiratory disorders represent a world epidemic. Their incidence and prevalence in the world population is increasing, and especially among elderly subjects, they are commonly associated with other pathologies, often generating a status of high clinical complexity. Neurology, internal medicine, and pneumology specialists should be aware of the common background of these disorders in order to treat correctly the patient’s comorbid state and optimize the treatment considering potential overlaps. In this review, we aimed to focus on the relationships between chronic respiratory disorders and chronic neurodegenerative diseases at different levels; we review the shared risk factors and the interactions between disorders, the indications to explore respiratory function in neurodegenerative diseases, pathology-pathology and drug-pathology interactions in patients affected by both chronic neurologic and respiratory diseases.

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“…Die Einnahme dieser Medikamente wird in verschiedenen Studien mit Übelkeit und Erbrechen in einem Prozentsatz zwischen 5 und 31% in Verbindung gebracht. Es gibt nur einen Fallbericht, in dem dieser Effekt mit einer Aspirationspneumonie in Verbindung gebracht wird [69]. Donepezil scheint jedoch eine Wirkung auf die Verringerung der SDB zu haben [70].…”

Section: Introductionunclassified

Chronische Atemwegserkrankungen und neurodegenerative Erkrankungen: Ein Leitfaden für den praktizierenden Kliniker

et al. 2022

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Chronische Atemwegserkrankungen stellen eine weltweite Epidemie dar. Ihre Inzidenz und Prävalenz in der Weltbevölkerung nimmt zu, und insbesondere bei älteren Menschen treten sie häufig in Verbindung mit anderen Krankheiten auf, was häufig zu einen Status hoher klinischer Komplexität. Fachärzte für Neurologie, Innere Medizin und Pneumologen sollten sich des gemeinsamen Hintergrunds dieser Erkrankungen bewusst sein, um den komorbiden Zustand des Patienten richtig zu behandeln und die Therapie unter Berücksichtigung möglicher Überschneidungen zu optimieren. In dieser Übersichtsarbeit konzentrieren wir uns auf die Beziehungen zwischen chronischen Atemwegserkrankungen und chronischen neurodegenerativen Erkrankungen auf verschiedenen Ebenen; wir untersuchen die gemeinsamen Risikofaktoren und die Wechselwirkungen zwischen den Erkrankungen, die Indikationen für die Untersuchung der Atemfunktion bei neurodegenerativen Erkrankungen und die Wechselwirkungen zwischen Pathologie und Pathologie sowie zwischen Medikamenten und Pathologie bei Patienten, die sowohl von chronischen neurologischen als auch von respiratorischen Krankheiten betroffen sind.

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Fatal Aspiration Pneumonia during Transition from Donepezil to Rivastigmine

Abstract: A washout period should be considered when switching between ChE inhibitors to minimize the risk of vomiting and aspiration.

Cited by 13 publications

References 4 publications

Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology

Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology

Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician

Chronische Atemwegserkrankungen und neurodegenerative Erkrankungen: Ein Leitfaden für den praktizierenden Kliniker

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