Trending Clinical Topics for July 2019

Ryan Syrek

Disclosures

July 26, 2019

Trending Clinical Topic of the Week (July 6-12): Anticholinergic Drugs

News that quantified a long-held concern, a potential new indication, and an alternative treatment option helped to make anticholinergic drugs this week's top trending clinical topic. Although anticholinergic medications are well known to affect cognition, new findings have demonstrated just how important this association may be. A large observational study has concluded that anticholinergic drugs may account for 10% of dementia cases, provided that the association is definitively found to be a causal effect. As one expert explained, this would mean that the medications may be responsible for 50,000 cases of dementia each year in the United States alone.

Although the risks of long-term use are clearly worth consideration, a separate study recently found that hyoscyamine, an anticholinergic drug, may allow some patients to avoid requiring a pacemaker. Certain patients with slow ventricular response during atrial fibrillation (AF) were shown to benefit from hyoscyamine use. This may provide an alternative approach for patients with AF who have comorbidities that preclude pacemaker implementation.

In regard to alternative treatments, new findings suggest that behavioral therapy may be better than anticholinergics at treating urinary incontinence in women. A behavioral approach was significantly more effective in achieving cure than anticholinergics alone among first-line and second-line interventions for urge urinary incontinence. In fact, either alone or combined with other treatment strategies, behavioral therapy was generally more effective than other monotherapies for both urge and stress urinary incontinence. Pros, cons, and alternatives all combined to help make anticholinergic drugs this week's top trending clinical topic.

Read more about anticholinergic toxicity.

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