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Prescribing of anticholinergic medicines to patients initiating dementia medicines
  1. Teck K Khong,
  2. Christopher J D Threapleton
  1. Clinical Pharmacology, St George's, University of London, London, UK
  1. Correspondence to Dr Teck K Khong, Clinical Pharmacology, St George's University of London, London, UK; tkhong{at}

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Commentary on: Narayan SW, Pearson SA, Litchfield M, et al. Anticholinergic medicines use among older adults before and after initiating dementia medicines. BJCP 2019;85:1957–1963.

Commentary by: Dr Christopher JD Threapleton and Dr Teck Khong, Clinical Pharmacology, St George's, University of London, UK

Series Editor: Dr Teck Khong, DTB Associate Editor, Clinical Pharmacology, St George's, University of London, London, UK

Key learning points

  • In an Australian cohort study, medicines with anticholinergic effects were commonly prescribed just before or after initiation of dementia medicines.

  • Almost one-third of patients who started dementia medicines received a medicine with anticholinergic effects.

  • Antipsychotics were the most commonly prescribed medicines with anticholinergic effects in this cohort.

  • Non-pharmacological management for non-cognitive symptoms of dementia should be optimised, and careful consideration given before initiating other medicines, especially those with anticholinergic effects.

Despite well-documented risks in older adults, anticholinergic medicines were commonly dispensed to patients just prior to and after initiating dementia medicines.1

Study details

This Australian retrospective cohort study investigated anticholinergic medicine use among older adults initiated on dementia medicines.1 It analysed the dispensing history of an anonymised 10% random sample from the Pharmaceutical Benefits Scheme, which provides subsidised access to medicines for all citizens and permanent residents of Australia. Data were extracted from July 2012 through to December 2017. The study included all adults from the …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; internally peer reviewed.