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geri:dementia:alzheimers [on February 9, 2024]
psychdb [Deprescribing] 		geri:dementia:alzheimers [on February 9, 2024]
psychdb [Deprescribing]
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 ==== Deprescribing ==== ==== Deprescribing ====
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 +See also: **[[https://​pubmed.ncbi.nlm.nih.gov/​20849673/​|Herrmann,​ N., Black, S. E., Li, A., & Lanctôt, K. L. (2011). Discontinuing cholinesterase inhibitors: results of a survey of Canadian dementia experts. International psychogeriatrics,​ 23(4), 539-545.]]**
 +</​alert>​
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   * Consider [[geri:​1-giants#​polypharmacy|deprescribing]] medications that may worsen cognition, including [[meds:​toxidromes:​anticholinergic-cholinergic|anticholinergic medications]].   * Consider [[geri:​1-giants#​polypharmacy|deprescribing]] medications that may worsen cognition, including [[meds:​toxidromes:​anticholinergic-cholinergic|anticholinergic medications]].
 +    * Deprescribing can be safe and effective.[([[https://​pubmed.ncbi.nlm.nih.gov/​26482056/​|Herrmann,​ N., O'​Regan,​ J., Ruthirakuhan,​ M., Kiss, A., Eryavec, G., Williams, E., & Lanctot, K. L. (2016). A randomized placebo-controlled discontinuation study of cholinesterase inhibitors in institutionalized patients with moderate to severe Alzheimer disease. Journal of the American Medical Directors Association,​ 17(2), 142-147.]])]
   * If deprescribing does not go well and there are increased behavioural symptoms, restart the medication at the //lowest// dose and **not** back to the original dose, as patients may develop prominent GI symptoms including nausea and vomiting!   * If deprescribing does not go well and there are increased behavioural symptoms, restart the medication at the //lowest// dose and **not** back to the original dose, as patients may develop prominent GI symptoms including nausea and vomiting!
 ===== Resources ===== ===== Resources =====