Box 3.
Adverse events associated with anticholinergic drug treatment.95
| A patient with PD, reported that sialorrhoea was the
symptom of their disease causing the majority of their
concern, because they were unable to sit down to read
the newspaper without experiencing severe sialorrhoea.
After no response to nonpharmacological methods of
management, off-label oral administration of atropine
eye drops (10 mg/ml 0.5 ml per day) was
trialled. Over the next 24 h, the patient became delirious and experienced hallucinations that resulted in a car crash and hospitalization. Treatment with anticholinergic drugs, such as atropine, can cause delirium and inhibited cognitive performance by blocking muscarinic receptors in the brain. This is particularly apparent in PD patients who have dementia. Atropine treatment was stopped, and the patient returned to normal 48 h later. For patients with PD, the potential side effects of anticholinergic drugs should be considered, and a decision made as to whether this risk is acceptable. In order to avoid unnecessary, and potentially dangerous side effects, it may be more appropriate to avoid anticholinergic drugs in patients with cognitive impairment. |
PD, Parkinson’s disease.