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Atropinic burden of prescriptions forms in patients with Alzheimer disease: a cross-sectional study in a French PharmacoVigilance Database

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Aim

Atropinic drugs in patients with Alzheimer disease (AD) can decrease the effects of anticholinesterase drugs and/or induce adverse drug reactions (ADRs). Several atropinic risk scales defining an atropinic burden of drugs were proposed but were little used in AD patients.

Methods

All ADRs’ notifications of AD patients registered in the Midi-Pyrénées PharmacoVigilance Database between 1999 and 2013 were analyzed using Anticholinergic Drug Scale (ADS) and Anticholinergic Duran’s list. The primary objective was to quantify atropinic burden in AD patients and the secondary one to investigate associated factors.

Results

Among the 475 notifications, at least one atropinic drug was found in 282 notifications (59.4 %) according to ADS and 214 (45.1 %) according to Duran. Mean number of atropinics per notifications was 0.9 ± 0.9 (ADS) and 0.7 ± 0.9 (Duran). Mean atropinic burden per notifications was 1.2 ± 1.5 (ADS) and 0.9 ± 1.3 (Duran). Atropinic burden ≥ 3 was found in 87 notifications (18.2 %) according to ADS and 50 (10.5 %) according to Duran. There was no association between atropinic burden and age of patients. The number of drugs is associated to a high atropinic burden.

Conclusion

The present work found an association between an atropinic drug and an anticholinesterase agent in around 1 out of 2 AD patients and a clinically significant atropinic burden (≥3) in around 1 to 2 AD patients out of 10. The benefit harm balance of atropinic drugs must be discussed before each prescription in AD patients.

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Conflict of interest

The authors declare that they have no competing interests.

Financial support

The work was performed during the university research time of the authors using the database which is available without fees in the department of the authors.

Contributors

François Montastruc designed the study, analyzed the data, and wrote the manuscript. Sarah Rouanet performed the analysis, analyzed the data, prepared the results, and reviewed the manuscript. Virginie Gardette analyzed the data and reviewed, corrected, and approved the manuscript. Vanessa Rousseau performed the statistical analyses, reviewed, corrected, and approved the manuscript. Haleh Bagheri designed the study, analyzed the data, reviewed, corrected, and approved the manuscript. Jean-Louis Montastruc designed the study, analyzed the data, and wrote the manuscript.

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Authors and Affiliations

  1. Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d’Information sur le Médicament, Equipe de Pharmacoépidémiologie de l’UMR INSERM 1027, Faculté de Médecine de l’Université Paul-Sabatier et Centre Hospitalier Universitaire de Toulouse, Toulouse, France

    François Montastruc, Sarah Rouanet, Vanessa Rousseau, Haleh Bagheri & Jean-Louis Montastruc

  2. Service d’Epidémiologie, UMR INSERM 1027, Faculté de Médecine de l’Université Paul-Sabatier et Centre Hospitalier Universitaire de Toulouse, Toulouse, France

    Virginie Gardette

Authors
  1. François Montastruc
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  2. Sarah Rouanet
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  3. Virginie Gardette
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  4. Vanessa Rousseau
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  6. Jean-Louis Montastruc
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Correspondence to Jean-Louis Montastruc.

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Montastruc, F., Rouanet, S., Gardette, V. et al. Atropinic burden of prescriptions forms in patients with Alzheimer disease: a cross-sectional study in a French PharmacoVigilance Database. Eur J Clin Pharmacol 71, 891–895 (2015). https://doi.org/10.1007/s00228-015-1869-0

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  • DOI: https://doi.org/10.1007/s00228-015-1869-0

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