{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T02:24:39Z","timestamp":1775874279692,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Drugs commonly prescribed for heart rate control may induce adverse drug reactions in Alzheimer patients treated with acetylcholinesterase inhibitors (AChEIs). We have studied use of drugs with a known risk of Torsades de pointes (TdP) and drugs used to treat behavioral and psychological symptoms of dementia, as well as a combination of drugs with a known risk of TdP and drugs with a known heart rate-lowering effect, before and after initiating treatment with AChEIs.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The study applied data from the Norwegian Prescription Database for the period 2004\u20132016. Prescriptions of concomitant use of drugs in persistent users of AChEIs was studied in a follow-up period from 4\u00a0years before to 2\u00a0years after AChEI initiation in men and women of two age groups: 37\u201380 and 81\u201388\u00a0years.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A small number of patients were prescribed haloperidol (\u223c1.5% The second year after AChEI initiation), digoxin\/digitoxin (\u223c3%), and verapamil (\u223c1.3%), while a substantial proportion of the patients were prescribed betablockers (\u223c28%) and citalopram\/escitalopram (\u223c17%). During follow-up, up to 6% of the study population were prescribed both betablockers and citalopram\/citalopram in addition to AChEIs, a combination that increased over the follow-up period and was observed most frequently in women in the oldest age group.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> A large proportion (\u223c44%) of patients treated with AChEIs were prescribed drugs that could cause bradycardic and prolonged time from the start of the Q wave to the end of the T wave (QT interval). Thus, action should be taken to reduce the combination of drugs with risk of bradycardia and prolonged QT interval. Medication review on a regular basis could be an option as an important risk-reducing intervention.<\/jats:p>","DOI":"10.3389\/fphar.2021.791578","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T07:31:02Z","timestamp":1645515062000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of Drugs With Risk of Heart Rate-Related Problems is Common in Norwegian Dementia Patients Treated With Acetylcholinesterase Inhibitors: A Prevalence Study Based on the Norwegian Prescription Database"],"prefix":"10.3389","volume":"12","author":[{"given":"Anne Sverdrup","family":"Efjestad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hege","family":"Ihle-Hansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidar","family":"Hjellvik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut","family":"Engedal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hege Salvesen","family":"Blix","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"B1","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology2017"},{"key":"B2","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.psym.2017.10.009","article-title":"QT prolongation, Torsades de pointes, and psychotropic medications: a 5-year update","volume":"59","author":"Beach","year":"2018","journal-title":"Psychosomatics"},{"key":"B3","doi-asserted-by":"publisher","first-page":"947","DOI":"10.2165\/00023210-200317130-00002","article-title":"Clinically Significant Drug Interactions with Cholinesterase Inhibitors: a Guide for Neurologists","volume":"17","author":"Bentu\u00e9-Ferrer","year":"2003","journal-title":"CNS Drugs"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1007\/s00228-014-1750-6","article-title":"Electrocardiographic Monitoring for New Prescriptions of Quetiapine Co-prescribed with Acetylcholinesterase Inhibitors or Memantine from 2005 to 2009. 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