Hallucinations With Tolterodine

Williams, Scott; Staudenmeier, James J.

doi:10.1176/appi.ps.55.11.1318-a

Cited by 17 publications

(7 citation statements)

References 1 publication

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“…In vivo studies investigating whether fesoterodine causes cognitive impairment appear to be absent, but several case reports have demonstrated that tolterodine can induce cognitive decline, hallucinations, confusion, agitation, anxiety, and delirium 10–12 . However, data from the current study indicate a substantial concentration dependency in AA of tolterodine, with an almost 40‐fold difference between in vitro activities detected at high and low therapeutic serum concentrations.…”

Section: Discussioncontrasting

confidence: 64%

Evaluation of Brain Anticholinergic Activities of Urinary Spasmolytic Drugs Using a High-Throughput Radio Receptor Bioassay

Jakobsen

Kersten²,

Molden³

2011

Journal of the American Geriatrics Society

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Section: Discussioncontrasting

confidence: 64%

Evaluation of Brain Anticholinergic Activities of Urinary Spasmolytic Drugs Using a High-Throughput Radio Receptor Bioassay

Jakobsen

Kersten²,

Molden³

2011

Journal of the American Geriatrics Society

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“…There is a single case report of delirium related to solifenacin treatment, which resolved following a switch to darifenacin [85] and two reports of hallucinations associated with tolterodine treatment, both in cognitively intact patients [59,86]. These events seem rare given the frequency of use of these medications, but they do reflect that they should be used with care, particularly in those who might be considered cognitively at risk.…”

Section: Bladder Antimuscarinics and Deliriummentioning

confidence: 99%

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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“…Instances of patients becoming confused or delirious after tolterodine use have been reported [31][32][33][34]. These occurrences appear to be infrequent and, if present, transient.…”

Section: Tolterodinementioning

confidence: 99%

Antimuscarinic Drugs: Review of the Cognitive Impact When Used to Treat Overactive Bladder in Elderly Patients

2011

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The blockade of muscarinic receptors in the management of overactive bladder (OAB) symptoms provides beneficial as well as adverse effects. The cognitive changes observed are caused by the drugs' ability to cross the blood-brain barrier and bind to muscarinic receptors within the central nervous system (CNS). To date, while not specifically testing for CNS side effects, most of the controlled efficacy trials of multiple OAB medications have not shown significant adverse effects on cognitive function. However, elderly individuals, in whom OAB is more prevalent, often are excluded from these studies. The few trials that have performed cognitive testing in healthy elderly people taking antimuscarinics have clearly shown that oxybutynin can adversely affect cognition. Darifenacin, trospium, solifenacin, and tolterodine appear to have little to no risk of causing CNS side effects in this population. However, caution needs to be used in elderly patients with preexisting dementia.

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Hallucinations With Tolterodine

Cited by 17 publications

References 1 publication

Evaluation of Brain Anticholinergic Activities of Urinary Spasmolytic Drugs Using a High-Throughput Radio Receptor Bioassay

Evaluation of Brain Anticholinergic Activities of Urinary Spasmolytic Drugs Using a High-Throughput Radio Receptor Bioassay

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

Antimuscarinic Drugs: Review of the Cognitive Impact When Used to Treat Overactive Bladder in Elderly Patients

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