Abstract
- The cholinesterase inhibitors donepezil, rivastigmine and galantamine have a modest and transient benefit in Alzheimer’s disease. Their known adverse effects include bradycardia.
- A Canadian case-control study conducted between 2003 and 2008 showed a statistically significant increase in the risk of hospitalisation for bradycardia among patients who had been taking a cholinesterase inhibitor for less than 3 months, compared with patients who had stopped taking a cholinesterase inhibitor more than 6 months previously.
- After hospital discharge, more than half of these patients were again prescribed a cholinesterase inhibitor, and 4% of them were re-admitted for bradycardia.
- In practice, when an adverse effect has been identified and treated, this information must be shared and taken into account by all those involved in the patient’s subsequent management.
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©Prescrire 1 April 2011
"Bradycardia due to cholinesterase inhibitors: identify adverse effects and take them into account" Prescrire Int 2011; 20 (115): 95 (Pdf, free).