Health and Disability

Results of a study were published last week looking at the cumulative use of strong anticholinergics on the development of dementia in the elderly (those aged 65 years). ¹ The results revealed that long term use of one or several drugs with anticholinergic effects could be associated with an increased risk of dementia, includingAlzheimer's disease.¹ Anticholinergics are used to treat the symptoms of overactive bladder (OAB), as well asdepression and allergy related conditions such as hay fever.

Many patients with OAB will continue to be treated successfully with anticholinergic drugs, but if there are concerns regarding high anticholinergic burden (e.g. in elderly patients on multiple treatments), alternative treatments for OAB are available, and should be considered, and NICE guidelines should be referred to. ⁹

Betmiga (mirabegron) is a selective β3-adrenoreceptor agonist that has been accepted for use by the SMC¹⁰ and is recommended by NICE¹¹ as an option for treating patients with symptoms of OAB in whom antimuscarinic drugs are contraindicated, clinically ineffective, or have unacceptable side effects. This means that Betmiga belongs to a different class of OAB therapeutics which does not contribute to anticholinergic burden. The decision regarding prescribing the most beneficial treatment for patients suffering OAB symptoms shall be based on judgement of health care practitioners.