Drugs That Can Give You Dementia
If its not shocking enough that dementia kills more people than breast cancer and prostate cancer combined, how about this
You may be taking a common medication right now that increases your risk of developing dementia by as much as 54 percent!
To date, a few studies have raised a number of medications into the dementia-causing spotlight. You may want to take this list and have a look in your medicine cabinet
Where To Learn About Other Drugs That Affect Brain Function
Many other drugs that affect brain function, but they are either not used as often as the ones above, or seem to affect a minority of older adults.
Notably, there has been a lot of concern in the media about statins, but a meta-analysis published in 2015 could not confirm an association between statin use and increased cognitive impairment. In fact, a 2016 study found that statin use was associated with a lower risk of developing Alzheimers disease.
This is not to say that statins arent overprescribed or riskier than we used to think. And its also quite possible that some people do have their thinking affected by statins. But if you are trying to eliminate medications that dampen brain function, I would recommend you focus on the ones I listed above first.
For a comprehensive list of medications identified as risky by the experts at the American Geriatrics Society, be sure to review the 2019 Beers Criteria.
You can also learn more about medications that increase fall risk in this article: 10 Types of Medications to Review if Youre Concerned About Falling.
Does That Mean Its Not Safe To Take Over
There are different antihistamines, and Benadryl is among the worst in terms of cognitive side effects. Other types of antihistamines are used to treat allergies, but none of them are used in sleep aids. Its important to find one that allows you to function well and control your allergy symptoms. The best way to do that is to consult your physician.
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Can Allergy Medications Harm Your Brain
It’s allergy season and many of us will be reaching into the medicine cabinet for relief. But it is important to choose wisely, as some allergy medications can harm brain health and increase dementia risk.
Diphenhydramine is a first-generation antihistamine medication . In addition to treating allergy and cold symptoms such as sneezing and watery eyes, it also blocks the actions of acetylcholine. This is a neurotransmitter that is important for brain functions including learning and memory. Diphenhydramine is classified as an anticholinergic drug, and a study of this class of drug found that increased use is associated with an up to 54% increased risk of dementia .
SAFER ALTERNATIVES
The good news is that newer antihistamines equal the effectiveness of diphenhydramine with few or no cognitive side effects. These medications were developed to minimize adverse events common to diphenhydramine and other older antihistamines .
If you’re older or have concerns about brain health, consider an allergy medication other than diphenhydramine. In addition to the medications above, topical nasal sprays and allergy shots are available by prescription and can also help alleviate symptoms. As always, it’s a good idea to discuss your options with a medical professional.
Q Is There Any Evidence That Anticholinergic Drugs Increase Your Risk For Dementia
A. There is evidence that certain medications both prescription and over-the-counter are associated with an increased risk of dementia. The latest study to confirm this connection came out in June 2019 in the Journal of the American Medical Association . This large, robust study showed a definite link between anticholinergic medications and patients who have dementia, but it didnt prove that there was a direct cause.
Given the known increased risk of dementia with certainmedications, we try to get patients off of these medications, if possible. Wehave seen patients cognition improve as a result.
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Diphenhydramine Side Effects In Older Or Elderly People
Over-the-counter sleep aids, especially those that contain diphenhydramine , are a relatively common choice for people with insomnia.
However, older people shouldn’t use medicines containing diphenhydramine, as they may be prone to dangerous side effects, including:
- Confusion
Further Evidence Found Of Association Between Anticholinergics And Alzheimer’s Disease In University Of Washington / Group Health Study In Jama Internal Medicine
SEATTLEA large study links a significantly increased risk for developing dementia, including Alzheimers disease, to taking commonly used medications with anticholinergic effects at higher doses or for a longer time. Many older people take these medications, which include nonprescription diphenhydramine . JAMA Internal Medicine published the report, called Cumulative Use of Strong Anticholinergics and Incident Dementia.
The study used more rigorous methods, longer follow-up , and better assessment of medication use via pharmacy records to confirm this previously reported link. It is the first study to show a dose response: linking more risk for developing dementia to higher use of anticholinergic medications. And it is also the first to suggest that dementia risk linked to anticholinergic medications may persistand may not be reversible even years after people stop taking these drugs.
Older adults should be aware that many medicationsincluding some available without a prescription, such as over-the-counter sleep aidshave strong anticholinergic effects, said Shelly Gray, PharmD, MS, the first author of the report, which tracks nearly 3,500 Group Health seniors participating in the long-running Adult Changes in Thought , a joint Group HealthUniversity of Washington study funded by the National Institute on Aging. And they should tell their health care providers about all their over-the-counter use, she added.
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Common Anticholinergic Drugs Like Benadryl Linked To Increased Dementia Risk
- By Beverly Merz, Executive Editor, Harvard Women’s Health Watch
One long-ago summer, I joined the legion of teens helping harvest our valleys peach crop in western Colorado. My job was to select the best peaches from a bin, wrap each one in tissue, and pack it into a shipping crate. The peach fuzz that coated every surface of the packing shed made my nose stream and my eyelids swell. When I came home after my first day on the job, my mother was so alarmed she called the family doctor. Soon the druggist was at the door with a vial of Benadryl tablets. The next morning I was back to normal and back on the job. Weeks later, when I collected my pay , I thanked Benadryl.
Today, Im thankful my need for that drug lasted only a few weeks. In a report published in JAMA Internal Medicine, researchers offers compelling evidence of a link between long-term use of anticholinergic medications like Benadryl and dementia.
Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinsons disease.
Commonly Prescribed Meds Could Raise Dementia Risk
MONDAY, June 24, 2019 — Doctors often prescribe anticholinergic drugs for a variety of ills. But a new study suggests stronger forms of these drugs may increase the risk of dementia in older patients.
These medicines include everything from milder medicines such as Benadryl to more potent medicines, such as certain antipsychotics and Parkinson’s meds. They’re used to treat a wide range of other conditions, including depression, chronic obstructive pulmonary disease, overactive bladder, allergies, and gastrointestinal disorders.
Anticholinergic drugs help contract and relax muscles, and work by blocking acetylcholine, a chemical that transmits messages in the nervous system.
But the new British study found that people aged 55 and older who took strong anticholinergic medications daily for three years or more had a 50% increased risk of dementia.
“Our study adds further evidence of the potential risks associated with strong anticholinergic drugs, particularly antidepressants, bladder antimuscarinic drugs, anti-Parkinson drugs and epilepsy drugs,” said study author Carol Coupland. She works in the division of primary care at the University of Nottingham.
Anticholinergics are known to cause short-term side effects — including confusion and memory loss — but it’s unclear if long-term use increases the risk of dementia.
There was no increased risk of dementia among patients who took other types of anticholinergic drugs such as antihistamines and gastrointestinal drugs.
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What Did The New Study Involve
The research, conducted by Carol Coupland, a professor of medical statistics in primary care at the University of Nottingham in England, and colleagues, evaluated anticholinergic drugs prescribed to nearly 285,000 people age 55 and older. About 59,000 of them had a diagnosis of dementia. The information came from a database of medical records from patients in more than 1,500 general practices in Britain, the authors said.
Researchers looked at the medical records of patients who were diagnosed with dementia and examined the drugs they had been prescribed from 11 years to one year before their diagnosis. They compared their medications during that time frame with those of people who did not have a diagnosis of dementia. They recorded which of 56 anticholinergic medications people were prescribed, and at what dose and how long. They accounted for factors like body mass index, smoking, alcohol consumption, other medical conditions and use of other medications.
The study found a 50 percent increased risk of dementia among people who used a strong anticholinergic drug daily for about three years within that 10-year period. The association was stronger for antidepressants, bladder drugs, antipsychotics and epilepsy medications, the study said. Researchers did not find any increased risk of dementia with antihistamines, bronchodilators, muscle relaxants or medications for stomach spasms or heart arrhythmias.
Why Is A Good Nights Sleep So Important To Overall Brain Health
One of the things were learning more about is that neurocognitive disorders arise from little perturbations in brain metabolism that lead to the gradual buildup of protein deposits over many years. Exposure to diphenhydramine over the short term can make older folks a little squirrely, but long-term use over many years may lead to Alzheimers disease.
If people are unable to achieve a good nights sleep, they really need to consult with a physician. Were learning more and more how important sleep is for not just short-term brain functioning, but for long-term brain functioning as well.
One of the current theories about what contributes to the development of neurodegenerative disorders is the accumulation of toxic substances in our brains over many years. Weve learned that sleep plays a role in eliminating these toxic substances. One of the consequences of not getting enough sleep is that these substances stay in the brain and cause a little bit of damage, which, multiplied over many years, can lead to a neurodegenerative disorder.
So a good nights sleep isnt just important for how you do the next day, but not sleeping well over a long period of time can have very dire consequences.
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Oxybutynin For Bladder Control
In the past five years, these bladder antimuscarinic drugs, prescribed for the treatment of urinary incontinence, have increased in usage by 31 percent. Researchers suggest there are other options but physicians turn to this drug because its a cheaper option. And it seems, at your expense
Researchers discovered that those taking it for more than three years had a significantly increased risk of dementia.
What can you do for bladder control instead?
What Are The Limitations Of The Research
An important caveat with this type of study is that it is observational meaning there is no way to know if the medication use played any direct role in causing dementia. All it shows is that the risk of developing dementia appears to be higher for people who take some of these medications.
Its also possible, the authors note, some conditions, like depression, may be early harbingers of cognitive decline. Its possible, for example, that some people taking antidepressants might actually be being treated for what will turn out to be an early symptom of dementia, so its their depression that goes along with an increased risk of dementia not the medicine they are taking to treat it.
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What The Study Found Regarding Benadryl And Dementia
A team led by Shelley Gray, a pharmacist at the University of Washingtons School of Pharmacy, tracked nearly 3,500 men and women ages 65 and older who took part in Adult Changes in Thought , a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system. They used Group Healths pharmacy records to determine all the drugs, both prescription and over-the-counter, that each participant took the 10 years before starting the study. Participants health was tracked for an average of seven years. During that time, 800 of the volunteers developed dementia. When the researchers examined the use of anticholinergic drugs, they found that people who used these drugs were more likely to have developed dementia as those who didnt use them. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.
The University of Washington study is the first to include nonprescription drugs. It is also the first to eliminate the possibility that people were taking a tricyclic antidepressant to alleviate early symptoms of undiagnosed dementia the risk associated with bladder medications was just as high.
What Does Previous Research Show
Other studies have also suggested that long-term use of some anticholinergic medications might increase the risk that older people will develop dementia.
For example, a 2015 study by researchers at the University of Washington found that people age 65 and older who took these medications for three years or more had a 54 percent greater risk of developing dementia than people who took the medications for three months or less.
A 2014 review found more than 30 studies that suggested confusion and other symptoms of cognitive decline increase with the amount of anticholinergic medication someone takes.
Dr. Malaz Boustani, director of the Regenstrief Center for Health Innovation and Implementation Science at Indiana University, has created a tool called the anticholinergic cognitive burden scale, which ranks drugs by their suspected effects on cognition. Experts suggest avoiding extended use of drugs with a rating of 3 on the scale or combinations of drugs that together rate 3 or higher.
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University Of Washington School Of Pharmacy
The UW School of Pharmacy is committed to educating the next generation of leaders in pharmacy, pharmaceutical research, and health carewhile seeking to ensure the safe, rational, and cost-effective use of medicines. Founded in 1894, the UW School of Pharmacy is ranked #3 in the world according to Shanghai Jiao Tong University. Follow the School of Pharmacy on or .
Common Allergy And Sleep Drugs Tied To Higher Alzheimers Risk
Some drugs commonly used to treat hay fever, insomnia and depression have been linked to a higher risk of Alzheimers disease and other forms of dementia, a new study reports. And the longer the medications are taken, the greater the risk.
The drugs include many popular prescription and over-the-counter medications. They include tricyclic antidepressants like doxepin , antihistamines like chlorpheniramine and diphenhydramine , and bladder control drugs like oxybutynin .
All of the medications are known to block a brain chemical called acetylcholine, which transmits nerve signals throughout the brain and nervous system. The drugs are known as anticholinergic agents and are commonly taken for disorders ranging from allergies and bladder problems to sleep and mood disorders. Common side effects of anticholinergic drugs include drowsiness, sore throat, retaining urine, and dry mouth and eyes.
Older adults should be aware that many medications including some available without a prescription, such as over-the-counter sleep aids have strong anticholinergic effects, said study author Shelly Gray, director of the geriatric pharmacy program at the University of Washington School of Pharmacy. While anyone taking these drugs should not stop taking them without consulting their doctor, effective substitutes may be available.
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What Should I Do If Im Taking One Of These Drugs
If you are taking any of these drugs or another drug that you believe is an anticholinergic drug, its important that you dont just stop taking it, especially if its been prescribed by your health provider.
Instead, have a conversation with your doctor about the medication. It may be that another drug can be substituted, or that lifestyle changes can effectively address the issue for which youre taking the drug. We also found that the dementia risk occurred in those taking anticholinergic drugs in higher amounts, often every day.
You can also read more about how to balance the risks and benefits of these common medications.
Executive director, Kaiser Permanente Washington Health Research Institute
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