- Last edited on February 9, 2024
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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 ==== | ||
+ | <alert type="info" icon="fa fa-book fa-lg fa-fw"> | ||
+ | See also: **[[https://pubmed.ncbi.nlm.nih.gov/20849673/|Herrmann, N. et al. (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 ===== |