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Tolterodine and memory: dry but forgetful
Kyle B Womack1, Kenneth M Heilman
1Department of Neurology, University of Florida College of Medicine, and the Neurology Service, Department of Veterans Affairs Medical Center, Gainesville, USA. kyle.womack@utsouthwestern.edu
Archives of Neurology
|May 21, 2003
Summary
Anticholinergic drugs can cause cognitive deficits. A patient experiencing memory loss improved significantly after discontinuing tolterodine, suggesting a potential link between tolterodine and cognitive dysfunction.
Area of Science:
- Pharmacology
- Neuroscience
- Geriatrics
Background:
- Anticholinergic medications are associated with cognitive impairment.
- Tolterodine tartrate, a bladder-selective anticholinergic, is marketed as having minimal cognitive side effects.
Observation:
- A 46-year-old woman presented with memory loss and deficits on cognitive testing.
- Her cognitive function and memory test scores improved markedly after discontinuing tolterodine therapy.
Findings:
- The patient's delayed free recall score on the Hopkins Verbal Learning Test-Revised was at the first percentile while taking tolterodine.
- After a one-month washout period, her score improved to above the 75th percentile on an alternative test form.
Implications:
- Tolterodine therapy may cause or exacerbate cognitive dysfunction in susceptible individuals.
- Cognitive side effects of tolterodine may be underdiagnosed due to lack of routine cognitive screening.
- Alternative explanations include aberrant drug metabolism or increased sensitivity in early Alzheimer disease.