Advances in Psychiatric Treatment (2007) 13: 178-184. doi: 10.1192/apt.bp.106.002725
© 2007 The Royal College of Psychiatrists
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Cardiovascular monitoring with acetylcholinesterase inhibitors: a clinical protocol{dagger}

Jeremy P. Rowland, John Rigby, Adam C. Harper and Rosalind Rowland

Jeremy Rowland is a senior house officer in old age psychiatry based at the Hesketh Centre (Merseycare NHS Trust, 51–55 Albert Road, Southport, Merseyside PR9 0LT, UK. Email: jezrowland{at}yahoo.com). He moved into psychiatry after initially training in general medicine and gaining membership of the Royal College of Physicians. John Rigby is a consultant psychiatrist and clinical director of the Older People’s Mental Health Services in Mersey Care NHS Trust. Adam Harper is a consultant geriatrician for Brighton and Sussex University Hospitals NHS Trust. Rosalind Rowland is a general physician currently studying at the Liverpool School of Tropical Medicine.

There has been significant anxiety among prescribers regarding the potential for cardiac adverse effects associated with acetylcholinesterase (AChE) inhibitors in Alzheimer’s disease. There is no consensus on how to manage this cardiovascular risk, and memory clinics vary widely in their practice. Review of published evidence reveals that the incidence of cardiovascular side-effects is low, and that serious adverse events are rare. Intensive cardiovascular screening such as pre-treatment electrocardiograms or 24 h cardiac monitoring is not justified. Furthermore, there are no high-risk groups to target. This article suggests pragmatic guidelines for managing cardiovascular risk in patients receiving AChE inhibitors. The guidelines are intended to be easy to incorporate into routine clinical practice in a memory clinic.


Related articles in APT:

A breath of pragmatism: Invited commentary on ... Cardiovascular monitoring with acetylcholinesterase inhibitors
Roger Bullock
APT 2007 13: 185-186. [Abstract] [Full Text]  



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R. Bullock
A breath of pragmatism: Invited commentary on ... Cardiovascular monitoring with acetylcholinesterase inhibitors
Advan. Psychiatr. Treat., May 1, 2007; 13(3): 185 - 186.
[Abstract] [Full Text] [PDF]