Which agent, although indicated for dementia associated with Parkinson disease, may cause tremors and should be used cautiously?

Rivastigmine is an acetylcholinesterase inhibitor that is commonly used to treat dementia associated with Parkinson's disease. It works by increasing the levels of acetylcholine, a neurotransmitter that is often deficient in such patients, thereby improving cognitive function and managing behavioral symptoms.

However, one of the potential side effects of rivastigmine is the exacerbation of tremors. This is particularly relevant for patients with Parkinson's disease, as tremors are a hallmark symptom of the condition. While rivastigmine can help with cognitive symptoms, its cholinergic effects can sometimes lead to increased neuromuscular irritability, potentially worsening existing motor symptoms such as tremors in individuals already suffering from Parkinson's disease.

Because of this potential side effect, it is crucial to use rivastigmine cautiously in patients with Parkinson's-related dementia, as balancing cognitive benefits against the risk of exacerbating motor symptoms is essential in managing the overall health of these patients. This caution is especially important in clinical practice, where the goal is to improve quality of life without worsening any existing symptoms of the underlying condition.