Medications for Alzheimer’s, Urinary Incontinence, and the Prescribing Cascade
Medications commonly used to treat Alzheimer’s Disease (AD), from a drug class known as the “cholinesterase inhibitors,” also can increase the risk of developing urinary incontinence (referred to as overactive bladder). There are three cholinesterase inhibitors available in the US:
- donepezil (Aricept®)
- galantamine (Razadyne ®)
- rivastigmine (Exelon®)
This adverse drug effect of cholinesterase inhibitors became well-documented after the medications were approved and more widely prescribed. It is important to be aware of and recognize this potential effect because it often leads to the addition of another medication to control the incontinence. Adding a drug to manage the side effects of another drug is referred to as a “prescribing cascade” and is one of the several causes of polypharmacy.