Abstract:
Anticholinergic-induced cognitive impairment may be partially reversible upon cessation. A barrier to deprescribing of anticholinergics is the unknown risk of anticholinergic adverse drug withdrawal events (ADWE), with only limited information available on the incidence, timing and severity of anticholinergic ADWE. We report the case of a 76-year-old woman who experienced significant cognitive improvement following deprescribing long-term use of a strong anticholinergic drug, doxepin, and dose reduction of another possible anticholinergic agent. The patient decided to abruptly stop taking doxepin, despite a planned careful taper with twice weekly monitoring, but did not experience any severe anticholinergic ADWE and subsequently had significantly improved cognitive function. Future research should focus on better understanding the risk of anticholinergic ADWE so that anticholinergic deprescribing decisions, including how often and by how much to taper, can be made confidently and safely.
摘要:
停药后,抗胆碱能引起的认知障碍可能部分可逆。解除抗胆碱能药物处方的障碍是抗胆碱能不良药物戒断事件(ADWE)的未知风险,关于发病率的信息有限,抗胆碱能ADWE的时机和严重程度。我们报告了一名76岁的女性,在长期服用强抗胆碱能药物后,认知功能得到了显着改善。多塞平,和另一种可能的抗胆碱能药物的剂量减少。病人决定突然停止服用多塞平,尽管计划每周两次监测,但未出现任何严重的抗胆碱能ADWE,随后认知功能显著改善.未来的研究应该集中在更好地了解抗胆碱能ADWE的风险,以便做出抗胆碱能药物治疗的决定。包括锥化的频率和锥化的程度,可以自信而安全地制作。