Anticholinergics

[Ollie123]

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Popular press coverage on a recent article linking these with dementia: Dementia risk tied to these commonly prescribed drugs, study says

Certainly not the definitive word, but I imagine coverage of this will make some neuro folks happy. I know this is a common concern I've been hearing discussed for a while now, with seemingly little change to prescribing practices.

 

[WisNeuro]

Yeah, I read this, it's not new, just another epidemiological study. There are some more quasi-experimental things out there, like improvement in cognition after discontinuing oxybutynin and such things. But yeah, hasn't changed prescribing habits much. I still get plenty of gero patients on massive amounts of anticholinergics, and a smaller, but still significant amount, on benzos and opiates. Definitely a lack of give a damn and/or knowledge of geriatrics and med effects in large segments of primary care and psychiatry.

 

[PsyDr]

I believe that they are going to discover that there are two basic neuropathololgical processes.

1) Integrity of the CNS gets messed up, whatever pathogens come to play, and result in some neuropathololgy (e.g., that study that showed dental DNA in Alz brains; JC virus exposure being associated with multifocal leuko).

2) Toxic exposure functions on a dose response curve, and will include things like Ach, BZs, ETOH, etc.

 

[AcronymAllergy]

Glad to see it getting coverage. I've also seen more CE's publicized that discuss prescribing in elderly patients. But outside of a few specialists (e.g., geropsychiatry), I've not yet seen substantial changes in prescribing habits. Then again, that's entirely anecdotal and based on just my own memory.

 

[Therapist4Chnge]

I don’t see a ton of 65+, but upwards of 30-40% of them come in on a benzo, z-sleep med, or both. They are often on pain meds too, but usually post-MVA, which is more understandable. Grandma’s little helpers can really jack up cognition for these folks. Good luck getting rid of them though...