Barrett Matthew J, Sargent Lana, Nawaz Huma, Weintraub Daniel, Price Elvin T, Willis Allison W
Department of Neurology Virginia Commonwealth University Richmond Virginia USA.
School of Nursing Virginia Commonwealth University Richmond Virginia USA.
Mov Disord Clin Pract. 2021 Oct 8;8(8):1181-1188. doi: 10.1002/mdc3.13347. eCollection 2021 Nov.
The relative importance of antimuscarinic anticholinergic medications for Parkinson's disease (PD) declined after the introduction of levodopa, such that anticholinergic medications are now much more likely to be prescribed for clinical indications other than parkinsonism. Recent studies have found an association between anticholinergic medication exposure and future risk of dementia in older individuals and those with PD. These findings provide a further reason to avoid the use of anticholinergic medications to treat motor symptoms of PD. More importantly, they raise the question of whether one of the goals of PD treatment should be to deprescribe all medications with anticholinergic properties, regardless of their indication, to reduce dementia risk. In this review, we discuss the use of anticholinergic medications in PD, the evidence supporting the association between anticholinergic medications and future dementia risk, and the potential implications of these findings for clinical care in PD.
左旋多巴问世后，抗毒蕈碱类抗胆碱能药物对帕金森病（PD）的相对重要性有所下降，因此抗胆碱能药物现在更有可能因帕金森综合征以外的临床适应症而被处方。最近的研究发现，抗胆碱能药物暴露与老年人及帕金森病患者未来患痴呆症的风险之间存在关联。这些发现为避免使用抗胆碱能药物治疗帕金森病的运动症状提供了进一步的理由。更重要的是，它们提出了一个问题，即帕金森病治疗的目标之一是否应该是停用所有具有抗胆碱能特性的药物，无论其适应症如何，以降低痴呆风险。在这篇综述中，我们讨论了抗胆碱能药物在帕金森病中的应用、支持抗胆碱能药物与未来痴呆风险之间关联的证据，以及这些发现对帕金森病临床护理的潜在影响。
