Reversible dementia and falls associated with biperiden

Abstract

Anticholinergic drugs may cause adverse effects, more often in the aged patients. We describe a case of reversible dementia and falls, associated with the use of biperiden. The patient was an 82-year old woman, admitted in a geriatric home because of frequent falls at home, progressive cognitive deficit and tremor of extremities with movement, in addition to remarkable loss of autonomy. As a matter of fact, she presented an essential tremor, which was mistakenly diagnosed as Parkinson disease and treated with biperiden; furthermore, she developed a drug-induced cognitive deficit, erroneously interpreted as Alzheimer disease. After submitted to the specialized evaluation, the anticholinergic drug was discontinued and there was a complete improvement of cognition changes; the essential tremor is under control with use of propranolol. When evaluating a patient with cognitive deficit, the clinician must discard possible causes of reversible dementia, especially the iatrogenic group.