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Seizures in Patients Receiving Concomitant Antimuscarinics and Acetylcholinesterase Inhibitor
Author(s) -
Piecoro Lance T.,
Wermeling Daniel P.,
Schmitt Frederick A.,
Ashford J. Wesson
Publication year - 1998
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1998.tb03944.x
Subject(s) - discontinuation , concomitant , anticholinergic , acetylcholinesterase , acetylcholinesterase inhibitor , medicine , pharmacology , drug , anesthesia , chemistry , enzyme , biochemistry
Seizures occurred in two patients with probable Alzheimer's disease who were receiving long‐term treatment with metrifonate, an irreversible acetylcholinesterase inhibitor. In both patients seizures were associated with discontinuation of short‐term agents with high antimuscarinic properties. Hence, abrupt discontinuation of antimuscarinics or anticholinergics with high antimuscarinic properties in patients receiving long‐term acetylcholinesterase inhibition therapy may be associated with a reduction of seizure threshold. With increasing administration of acetylcholinesterase inhibitors for patients with Alzheimer's disease, practitioners should be aware of the potential for drug‐drug interactions and other complications. In general, it is good medical practice to avoid concomitant administration with centrally acting anticholinergic agents.