Anticholinergic Discontinuation in Older People

Electronic Supplementary Material

Appendix 1: MEDLINE search strategy

Source / Search strategy: keyword/MeSH
MEDLINE (Ovid SP) 1946 to July 2013 /
  1. Cognition Disorders/ or Cognition/ or cogniti*.mp.

  1. Delirium/ or Delirium, Dementia, Amnestic, Cognitive Disorders/

  1. Dementia/

  1. Memory/ or Memory, Long-Term/ or Memory, Short-Term/

  1. or/1-4

  1. taper*.mp.

  1. reduc*.mp.

  1. cessation.mp.

  1. stop*.mp.

  1. withdraw*.mp.

  1. discontinu*.mp.

  1. drug withdrawal.mp.

  1. dechallenge.mp.

  1. or/6-13

  1. anticholinergic*.mp.

  1. antimuscarinic#.mp.

  1. Muscarinic Antagonists/

  1. Cholinergic Antagonists/

  1. Parasympatholytics

  1. cholinolytic*.mp.

  1. or/15-20

  1. Aged/

  1. older people.mp.

  1. elderly.mp.

  1. or/22-24

  1. randomized controlled trial.pt.

  1. controlled clinical trial.pt.

  1. randomi#ed.ab.

  1. placebo.ab.

  1. drug therapy.sh.

  1. randomly.ab.

  1. trial.ab.

  1. groups.ab.

  1. or26-33

  1. (animals not (humans and animals)).sh.

  1. 34 not 35

  1. 5 and 14 and 21 and 25 and 36

Appendix 2: Excluded studies table

Study / Reason for exclusion
Boustani MA, Campbell NL, Khan BA, Abernathy G, Zawahiri M, Campbell T, et al:Enhancing care for hospitalized older adults with cognitive impairment: a randomized controlled trial.J Gen Intern Med 2012, 27:561-7. / Does not focus on intervention
Campbell N, Boustani M, Lane K, Gao S, Hendrie H, Khan B, et al:Use of anticholinergics and the risk of cognitive impairment in an African American population.Neurology 2010, 75:152-9. / Does not focus on intervention
Carriere I, Fourrier-Reglat A, DartiguesJF, Rouaud O, Ancelin ML, et al:Drugs With Anticholinergic Properties, Cognitive Decline, and Dementia in an Elderly General Population The 3-City Study.Arch Intern Med 2009, 169:1317-24. / Cognitive performance scores were not clear
Castelino RL, Hilmer SN, Bajorek BV, Nishtala P, Chen TF:Drug burden index and potentially inappropriate medications in community-dwelling older people: The impact of home medicines review.Drugs Aging 2010, 27:135-48. / Does not focus on the intervention
Cohen-Mansfield J, Lipson S, Werner P, Billig N, Taylor L, Woosley R:Withdrawal of haloperidol, thioridazine, and lorazepam in the nursing home: A controlled, double-blind study.Arch Intern Med 1999, 159:1733-40. / Cognitive performance scores were not clear
Desmarais JE, Beauclair L, Margolese HC:Anticholinergics in the era of atypical antipsychotics: short-term or long-term treatment?J Psychopharmacol2012, 26:1167-74. / Review article
Fitzgerald DB, Crucian GP, Mielke JB, Shenal BV, Burks D, Womack KB, et al:Effects of donepezil on verbal memory after semantic processing in healthy older adults.CognBehavNeurol2008, 21:57-64. / Does not measure anticholinergic drug use
Fontaine CS, Hynan LS, Koch K, Martin-Cook K, Svetlik D, Weiner MF:A double-blind comparison of olanzapine versus risperidone in the acute treatment of dementia-related behavioral disturbances in extended care facilities.J Clin Psychiatry 2003, 64:726-30. / Does not focus on intervention
Fortin MP, Rouch I, Dauphinot V, Gedeon C, Krolak-Salmon P, et al:Effects of Anticholinergic Drugs on Verbal Episodic Memory Function in the Elderly A Retrospective, Cross-Sectional Study.Drugs Aging 2011, 28:195-204. / Does not focus on intervention
Furey ML, Drevets WC:Antidepressant efficacy of the antimuscarinic drug scopolamine - A randomized, placebo-controlled clinical trial.Arch Gen Psychiatry 2006, 63:1121-9. / Cognitive performance was not reported
Katona CL, Hunter BN, Bray J:A double-blind comparison of the efficacy and safety of paroxetine and imipramine in the treatment of depression with dementia.Int JGeriat Psychiatry 1998, 13:100-8. / Does not focus on intervention
Koshoedo S, Soiza RL, Purkayastha R, Mangoni AA:Anticholinergic Drugs and Functional Outcomes in Older Patients Undergoing Orthopaedic Rehabilitation.Am J GeriatrPharmacother 2012, 10:251-7. / Cognitive performance was not reported
Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C:Efficacy of oral extended-release oxybutynin in cognitively impaired older nursing home residents with urge urinary incontinence: a randomized placebo-controlled trial.J Am Med DirAssoc2011, 12:639-47. / Does not focus on intervention
Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C:Randomized, placebo-controlled trial of the cognitive effect, safety, and tolerability of oral extended-release oxybutynin in cognitively impaired nursing home residents with urge urinary incontinence.J Am GeriatrSoc 2008, 56:862-70. / Does not focus on intervention
Liang CS, Ho PS, Shen LJ, et al: Comparison of the efficacy and impact on cognition of glycopyrrolate and biperiden for clozapine-induced sialorrhea in schizophrenic patients: A randomized, double-blind, crossover study.Schizophr Res 2010, 119:138-44. / Does not focus on intervention
Mori K, Nagao M, Yamashita H, Morinobu S, Yamawaki S:Effect of switching to atypical antipsychotics on memory in patients with chronic schizophrenia.ProgNeuropsychopharmacolBiol Psychiatry 2004, 28:659-65. / Does not measure anticholinergic discontinuation
Mori K, Yamashita H, Nagao M, Horiguchi J, Yamawaki S:Effects of anticholinergic drug withdrawal on memory, regional cerebral blood flow and extrapyramidal side effects in schizophrenic patients.Pharmacopsychiatry2002, 35:6-11. / Population mean age <65 years
Pitkala KH, Juola AL, Soini H, Laakkonen ML, Kautiainen H, Teramura-Gronblad M, et al:Reducing inappropriate, anticholinergic and psychotropic drugs among older residents in assisted living facilities: study protocol for a randomized controlled trial.Trials 2012, 13:85. / Study protocol
Tohen M, Zhang F, Keck PE, Feldman PD, Risser RC, Tran PV, et al:Olanzapine versus haloperidol in schizoaffective disorder, bipolar type. J Affect Disord 2001, 67:133-40. / Population mean age ≤ 65 years
vanLaar MW, Volkerts ER, Verbaten MN, et al: Differential effects of amitriptyline, nefazodone and paroxetine on performance and brain indices of visual selective attention and working memory. Psychopharmacology 2002, 162:351-63. / Does not focus on intervention
Weston AL, Weinstein AM, Barton C, Yaffe K:Potentially inappropriate medication use in older adults with mild cognitive impairment.J Gerontol A BiolSci Med Sci2010, 65:318-21. / Does not focus on intervention

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