Posted on Jun 10, 2015 4:00:00 PM by Rebecca Anderson

Anticholinergics and Dementia

Examining Long-Term Concerns for OAB Drugs Man with too many drugs

When treating overactive bladder (OAB), it might be helpful to remember one of the most important lessons learned in high school – doing what’s popular isn’t always the right thing. Drug therapy is the most popular and frequent treatment for OAB, but according to clinical trials and published research, a majority of patients stop taking their medication within 90 days with 80% of patients discontinuing their medication by the end of one year. On top of that, there is growing concern about the link between long-term use of OAB drugs – often anticholinergics – and the development of dementia and Alzheimer’s Disease.

New Study

Anticholinergics hinder Acetylcholine (ACh) function in the body, thereby impacting nerve, muscle and brain activity. However, a well-known risk with anticholinergics is that a lack of ACh can result in forgetfulness and confusion. Now, newly published research in the Journal of the American Medical Association (JAMA), reveals the side-effects of these drugs may be far more debilitating and damaging than first thought.

According to a large prospective, long-term study published in JAMA Internal Medicine, 23.2% of the elderly patients taking Anticholinergic medication during a seven year period developed dementia, and 79.9% of the patients in that group (18.5% of the total) also developed Alzheimer’s disease. That’s a stark contrast to 11%, the normal incidence of Alzheimer’s Disease in people in 65 years and older, as reported by the Alzheimer’s Association.

Long-Term Concerns

In addition, the JAMA report notes that the risks associated with taking Anticholinergics may not be reversible, even after people stop taking the medication. The most common anticholinergic drugs used in the study were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. Quite a few common, over-the-counter medications contain anticholinergics.

Some of the concern regards how many, how much, and how long patients are using these medications. The anticholinergic study concludes with a recommendation to increase awareness among health care professionals and older adults about the potential medication related risks and the need to minimize anticholinergic use over time. Research has shown that in many health facilities, approximately half of all dementia patients routinely receive painkillers, antihistamines and psychiatric medications which are contraindicated and can make their symptoms worse, contributing to suffering, higher health costs and perhaps an increase in morbidity rates.

This JAMA study suggests that anticholinergic cycling may not be as benign as previously thought.

Percutaneous tibial nerve stimulation (PTNS) via the Urgent PC Neuromodulation System, is a drug free alternative for treating OAB. This 3rd-line treatment option has proven clinically effective in 60-80% of patients and is an ideal option for patients – including the elderly - who cannot tolerate drug side-effects.

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Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Urgent PC is a registered trademark of Cogentix Medical © 2015 Cogentix Medical. All rights reserved. 

Rebecca Anderson
Rebecca Anderson has been a marketer in the healthcare industry for over fifteen years, the last ten of which have been focused on Urgent PC and other products from Cogentix Medical. Rebecca has a special fondness for Urgent PC, having been part of the Uroplasty team that launched the product to U.S. and International markets.
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