Cholinesterase Inhibitors Shown to Have Side Effects Serious to Some Alzheimer's Patients

Caregiver, patient expert

All drugs have side effects. That's pretty much a universal factor. Most drugs that pass through rigorous testing and gain FDA approval are determined to have enough benefit to make any known risks acceptable. Often, however, it takes time for all side effects to become clear. Often, too, the significance of the effects isn't absorbed by the doctors prescribing the drugs.

From Canada comes a story titled, "Dementia drugs may put some patients at risk, Queen's study shows," that reports on a study about the side effects of some Alzheimer's medications. The study discussed in this article  focused on drugs given for Alzheimer's disease, namely Cholinesterase inhibitors sold as Aricept, Exelon and Reminyl. The drugs have been known to slow heart rates and cause fainting, but, according to the article, "the magnitude of these risks has not been clear until now."

The large Canadian study showed the number of test subjects "...experiencing a slowed heart-rate was 69 per cent more common amongst cholinesterase inhibitor users. In addition, people taking the dementia drugs had a 49 per cent increased chance of having permanent pacemakers implanted and an 18 per cent increased risk of hip fractures."

The researchers, aware that there are few alternatives for people with diagnosed Alzheimer's disease, are not suggesting that the drugs not be prescribed. What they are suggesting is that doctors become more aware of the side effects. If the patient has already shown signs of a slowed heart rate or has fainting spells, then the benefits of giving the drug must be weighed more carefully than first thought.

Fainting, resulting in a fall, often means broken bones and hip fractures, especially, can prove to be fatal to the elderly. The researchers also warned that, if doctors aren't aware of the side effects of these drugs, they may subject the patient to an operation to implant a pacemaker for the heart. This operation, if unnecessary, is an added danger to the elder.

Knowledge is power. It's good to see these studies conducted as drugs for Alzheimer's disease become more widely used. It's quite possible that there will soon be alternative drugs on the market for people with diagnosed Alzheimer's disease. These drugs, too, will have side effects, but they may be different than the ones occurring with Cholinesterase inhibitors. The more choices available, the better a doctor will be able to fine tune treatment to fit a particular patient's health risks.

For now, doctors and patients must make careful decisions based on risk factors. That's nothing new. What is new is the increased awareness this study brought about. We'll watch for more educated prescribing and more careful monitoring, while we await alternate therapies.

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