Drugs with Anticholinergic Properties as a Risk Factor for Psychosis in Patients Affected by Alzheimer's Disease

Emerging evidence suggests that psychosis in persons with Alzheimer's disease (AD) may be linked to the cholinergic deficit associated with the disease. This study sought to evaluate whether anticholinergic (ACH) drugs could be a risk factor for psychosis onset. A total of 230 patients affected...

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Bibliographic Details
Published in:Clinical pharmacology and therapeutics 2008-07, Vol.84 (1), p.63-68
Main Authors: Cancelli, I, Valentinis, L, Merlino, G, Valente, M, Gigli, GL
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Alzheimer Disease - complications
Alzheimer Disease - psychology
Biological and medical sciences
Cholinergic Antagonists - adverse effects
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Humans
Male
Medical sciences
Middle Aged
Neurology
Organic mental disorders. Neuropsychology
Pharmacology. Drug treatments
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses, Substance-Induced - complications
Psychoses, Substance-Induced - psychology
Risk Factors
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Summary:Emerging evidence suggests that psychosis in persons with Alzheimer's disease (AD) may be linked to the cholinergic deficit associated with the disease. This study sought to evaluate whether anticholinergic (ACH) drugs could be a risk factor for psychosis onset. A total of 230 patients affected with probable AD were recruited. Data on behavioral and psychological symptoms were collected using the Neuropsychiatric Inventory, and diagnosis of psychosis was performed. Patients were divided into those who used ACH drugs and those who used non‐ACH drugs. Those using ACH drugs (18.3%) were more likely to have psychosis than those using non‐ACH drugs (odds ratio (OR)=2.52; 95% confidence interval (CI), 1.27–5.00); this association remained significant even after adjusting for potential confounding variables (OR=2.13; 95% CI, 1.03–4.43). Our data suggest that patients with AD are frequently treated with ACH drugs and that ACH drug intake should be regarded as a potential risk factor for psychosis. Clinical Pharmacology & Therapeutics (2008); 84, 1, 63–68 doi:10.1038/sj.clpt.6100435
ISSN:0009-9236
1532-6535
DOI:10.1038/sj.clpt.6100435