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Anticholinergic deprescribing: A case report demonstrating improved cognition and function with minimal adverse withdrawal effects.
Br J Clin Pharmacol
July 2024
Geriatric Day Hospital, Bruyère Continuing Care, Ottawa, Canada.
Anticholinergic-induced cognitive impairment may be partially reversible upon cessation. A barrier to deprescribing of anticholinergics is the unknown risk of anticholinergic adverse drug withdrawal events (ADWE), with only limited information available on the incidence, timing and severity of anticholinergic ADWE. We report the case of a 76-year-old woman who experienced significant cognitive improvement following deprescribing long-term use of a strong anticholinergic drug, doxepin, and dose reduction of another possible anticholinergic agent.
View Article and Find Full Text PDFIs trigeminal neuralgia the only definitive diagnosis for pain in a tooth extraction site?
BMC Oral Health
June 2021
Honorary Consultant in Orofacial Pain Department, International Campus Dental School, Tehran University of Medical Sciences, Tehran, Iran.
Knowing the International Classification of Orofacial Pain helps pain specialists to differentiate types of orofacial pain. It is important to select the best treatment or intervention for the patients based on the diagnosis. As part of our study, we reviewed the article published in BMC Oral Health, titled "Clinical characteristics and associated factors of trigeminal neuralgia: Experience from Addis Ababa, Ethiopia" by Ayele et al.
View Article and Find Full Text PDFDoxepin in children and adolescents with symptoms of insomnia: a single-center experience.
J Clin Sleep Med
May 2020
Division of Child Neurology, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York.
Study Objectives: Pediatric insomnia is a widespread problem and especially difficult to manage in children with neurodevelopmental disorders. There are currently no US Food and Drug Administration-approved medications to use once first-line therapy fails. The objective of this study was to evaluate the efficacy and tolerability of doxepin in pediatric patients.
View Article and Find Full Text PDFUse of Systemic Treatment in Patients with Chronic Pruritus: A Survey of Dermatologists in the Netherlands.
Acta Derm Venereol
March 2019
Department of Dermatology, Radboud university medical center, 6500HB Nijmegen, The Netherlands.
Treatment of chronic pruritus can be a challenge for clinicians. Several systemic treatments have been suggested to reduce itch, such as gabapentinoids and antidepressants. The aim of this study was to assess the current practice of dermatologists regarding systemic treatment in patients with chronic pruritus, and to identify possible barriers in the prescription of these treatments.
View Article and Find Full Text PDFGeriatric patients often experience insomnia because of physiological and neurological changes that occur during the aging process. Use of benzodiazepines, nonbenzodiazepine hypnotics, and diphenhydramine for the treatment of insomnia pose an increased risk of cognitive impairment, falls, and fractures in this patient population. Therapeutic alternatives approved by the Food and Drug Administration include suvorexant, doxepin, ramelteon, and tasimelteon, which have shown efficacy and safety in various studies.
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