Polypharmacy and Central Nervous System Adverse Effects of Anticholinergic Agents in the Men with Benign Prostate Hyperplasia

Hong, Woo Sung; Chung, Hong; Lee, Jun Min; Kim, Tong Wook; Kim, Hong Sup; Kim, Hyung Jee; Yang, Sang Kuk

Abstract

PURPOSE: Elderly patients commonly receive multiple drugs compared to young patients because of high comorbidity. Some common illnesses in the elderly with underlying diseases are complicated or aggravated by treatment with anticholinergic agents. We evaluated the use of anticholinergic agents and their adverse effects in the men with benign prostate hyperplasia.
MATERIALS AND METHODS
One hundred-eighty four patients over 40 years-old who visited hospital for the treatment of benign prostate hyperplasia and prescribed more than one anticholinergic agent from January 2005 to June 2006 were enrolled. The patients who took anticholinergics during less than 2 months or suffered from psychiatric problems were excluded. One hundred-fifteen patients were included and all prescribed drugs were classified and counted. The number of anticholinomimetic agents and their 10 adverse effects were checked.
RESULTS
Mean age was 67.0+/-10.6 years and mean cormobidity diseases counted 1.1+/-1.1. Mean pill and mean anticholinergic agents counted 7.3+/-4.3 and 1.8+/-1.1, respectively. Prescribed anticholinergic agents count increased with patient's age(p=0.401). As the patients took more medications, they had higher possibility to take anticholinergic agents. And as the patients took more anticholinergic agents, they showed more anticholinergic adverse effects(p<0.001).
CONCLUSION
Elderly patients mistakenly tend to attribute drug-induced changes in memory and cognitive function to aging or comorbid conditions. Therefore prescribers should consider an anticholinergic agent's receptor selectivity, ability to cross the blood-brain barrier, and pateint's medical history in elderly patients. Additionally physicians can actively perform Mini-Mental Status Examination for evaluation of the patient's cognitive functions under anticholinergic medication.