english.prescrire.org > Spotlight > Archives : 2006 > Alzheimer's drugs: can cause trembling and aggravate parkinsonian symptoms

Spotlight: Archives

Every month, the subjects in Prescrire’s Spotlight.

2006 : 1 | 30 | 60

Alzheimer's drugs: can cause trembling and aggravate parkinsonian symptoms

In patients with Alzheimer's-type dementia taking cholinesterase inhibitors, treatment should be halted if falls, difficulties in walking or Parkinsonian symptoms occur, given the limited and short-lived benefits of these drugs.

Cholinesterase inhibitor drugs donepezil, galantamine and rivastigmine are used in Alzheimer's disease, even though their efficacy is limited and short-lived.

Several clinical trials reveal a high frequency of adverse effects similar to Parkinsonian symptoms, including trembling, stiffness, movement disorder (dystonia), difficulty in performing voluntary movements (dyskinesia) and an inability to sit still (akathisia).

In patients with Parkinson's disease experiencing cognitive difficulties or suffering from dementia who are treated with cholinesterase inhibitors, the symptoms are sometimes aggravated by the treatment. Halting treatment often leads to an alleviation of the symptoms.

If adverse effects occur, in particular trembling or the appearance or aggravation of Parkinsonian symptoms, it is advisable to reconsider the patient's treatment with cholinesterase inhibitors, given the limited and short-lived effectiveness of these drugs.

©Prescrire December 2006

Source: "Anticholinestérasiques : tremblements et aggravation de symptômes parkinsoniens" Rev Prescrire 2006 ; 26 (278) : 824-826.

- More articles in Prescrire's "Spotlight"...