What To Do If You Or Your Relative Is On These Medications
So what should you do if you discover that your older relative or you yourself are taking some of these medications?
If its an over-the-counter anticholinergic, you can just stop it. Allergies can be treated with non-sedating antihistamines like loratadine , or you can ask the doctor about a nasal steroid spray. PM painkillers can be replaced by the non-PM version, and remember that the safest OTC analgesic for older adults is acetaminophen .
If you are taking an over-the-counter sleep aid, it contains a sedating antihistamine and those are strongly anticholinergic. You can just stop an OTC sleep aid, but in the short term, insomnia often gets worse. So youll need to address the insomnia with non-drug techniques.
You should also discuss any insomnia or sleep problems with your doctors its important to rule out pain and serious medical problems as a cause of insomnia but be careful: many of them will prescribe a sleeping pill, because they havent trained in geriatrics and they under-estimate the risks of these drugs.
If one or more of the medications above has been prescribed, dont stop without first consulting with a health professional. Youll want to make an appointment soon, to review the reasons that the medication was prescribed, alternative options for treating the problem, and then work out a plan to reduce or eliminate the drug.
Now go check out those medication bottles, and let me know what you find!
Benadryl And Other Medications
Below is a list of medications that can interact with Benadryl. This list doesnt contain all drugs that may interact with Benadryl.
Different drug interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
If you take other medications, talk with your pharmacist before taking Benadryl. Your pharmacist can help you avoid potential interactions.
Anticholinergic drugs
Anticholinergic drugs block the action of acetylcholine, a chemical that relays messages between cells in your body. Benadryl also blocks acetylcholine. Because anticholinergic drugs and Benadryl work in the same way, taking them together can increase the risk of side effects. Examples of these drugs include:
- fesoterodine
- zolpidem
Benadryl and Xanax
Xanax is a type of drug called a benzodiazepine, which can cause sleepiness. Taking Xanax with Benadryl can increase your risk of excessive sleepiness. This can make you too sleepy to drive or prevent you from doing other potentially dangerous activities safely.
If you take Xanax, talk with your doctor before taking Benadryl. They may recommend other treatment options.
Benadryl and Zoloft
Zoloft is an antidepressant that can cause sleepiness in some people who take it. Taking Zoloft with Benadryl may increase the risk of excessive sleepiness. This can make you too sleepy to drive or prevent you from doing other potentially dangerous activities safely.
Benadryl and Zyrtec
Could Something Else Be Causing The Dementia
Other factors that were not measured in the studies may have raised the risk for dementia. These factors include genes, certain medical conditions, and environmental exposures.
Some older adults may also take antihistamines to treat symptoms of early dementia, such as trouble sleeping. In that case, taking antihistamines would be a result of dementia rather than a cause of it.
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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.
Q What Medications Are Associated With Dementia Risk
A. The 2019 AmericanGeriatric Society Updated Beers Criteria provides recommendations onmedications that are potentially inappropriate in older adults. This criteriasuggests that medications like anticholinergics and hypnotics should be avoidedin patients with dementia if possible. Evidence suggests that these types ofmedications could contribute to or worsen dementia.
Anticholinergics
This broad category of medications includes drugs we use to treat urinary incontinence, depression, muscle spasms, and even allergies. Anticholinergic medications are also in products that you can buy over-the-counter.
Most over-the-counter medications for sleep or nighttime symptoms have diphenhydramine , or a similar type of medication, which can affect cognition. When older adults with cognitive concerns are taking these medications, we talk to them about alternative treatments that do not affect cognition. Other examples of anticholinergic drugs include cyclobenzaprine and oxybutynin .
Hypnotics
These medications include benzodiazepines and medications like zolpidem . Doctors often prescribe them to help with sleep or anxiety. Fortunately, there are alternative agents that can be used. So when patients have dementia or problems with memory, we often try to substitute a different medication with fewer cognitive effects.
Otherexamples of these drugs include diazepam ,lorazepam , and alprazolam
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Do Antihistamines Affect Memory
In the brain, they inhibit activity in the memory and learning centers, which can lead to memory loss. Alternatives: Newer-generation antihistamines such as loratadine and cetirizine are better tolerated by older patients and do not present the same risks to memory and cognition.
Why These Drugs Have A Stronger Effect In Older People
As we age, our ability to process medication changes. The kidneys and liver clear drugs more slowly, so drug levels in the blood remain higher for a longer time. People also gain fat and lose muscle mass over time. Both these changes affect the way drugs are distributed to and broken down in body tissues. And because these drugs are stored in body fat, they can continue to produce effects days after people stop taking them, especially in people with a higher proportion of body fat. In addition, older people tend to take more prescription and over-the-counter medications, each of which has the potential to suppress or enhance the effects of the others.
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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.
This study is another reminder to periodically evaluate all of the drugs youre taking. Look at each one to determine if its really helping.
Alcohol Use And Benadryl
You shouldnt drink alcohol while youre taking Benadryl. Alcohol can increase your risk of drowsiness or dizziness. It may also cause more serious side effects, such as trouble breathing or slowed breathing.
If you drink alcohol, talk with your doctor about other medications you can take to treat your cold or allergy symptoms.
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Other Side Effects Of Benadryl That Should Be Given Attention
Now you have known the answer to “does Benadryl cause dementia”, you’d better know that although Benadryl is an OTC drug taken for most conditions, this drug is also associated with several side effects that one should be aware of.
Common Side Effects of Benadryl
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Benadryl can greatly affect the respiratory system of a person. It can lead to an increased thickness of the lung or bronchial secretions which may lead to chest problems.
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Benadryl can cause drowsiness. One should avoid activities such as driving or operating machinery because the performance and safety may be affected.
Rare Side Effects of Benadryl
The sides effects may vary among individuals. When any of these signs of allergic reactions occur, immediately seek advice and help from medical doctors. Never take other OTC drugs as this might interact with each other, causing more serious health problems.
Knowing “does Benadryl cause dementia” and its other side effects would help you use this kind of drug more carefully. In fact, any kind of drugs, including over the counter drugs, should be understood thoroughly before taking and you’d better consult a doctor before taking them. And best of all, stay healthy!
Memory Loss Or Dementia
Taking Benadryl may cause memory loss or dementia. Although rare, this side effect may be more common in older adults or people whove taken the drug long term. Symptoms can include:
- trouble speaking or finding the right words to say
- trouble concentrating
What might help
If youre experiencing memory loss or dementia while taking Benadryl, talk with your doctor. Theyll likely suggest that you stop taking Benadryl. Theyll also look for the cause of your memory loss or dementia so that they can recommend the right treatment for you.
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People Should Not Stop Their Therapy But Talk To Their Health Care Provider
Prof. Gray urges people not to stop their therapy based on the findings of this study they should talk to their health care provider, and also tell them about all their over-the-counter drug use.
Health care providers should regularly review their older patients drug regimens including over-the-counter medications to look for chances to use fewer anticholinergic medications at lower doses, she says.
If providers need to prescribe anticholinergics to their patients because they offer the best treatment, then they should use the lowest effective dose, monitor the therapy regularly to ensure its working, and stop the therapy if its ineffective, she adds.
Although the link between raised risk of dementia and anticholinergics has been found before, the new study uses more rigorous methods including over 7 years of follow-up to establish the strength of the link. By accessing pharmacy records, the researchers were also able to include non-prescription use of anticholinergics in their data.
It is also the first study to show a dose-response effect, note the authors. That is, the higher the cumulative amount of drug taken, the higher the risk of developing dementia.
And another first for the study, is that it also shows that dementia risk linked to anticholinergics may persist long after people stop taking the drugs.
What Does The Research Say
Several studies have found a link between anticholinergics and dementia. While the research has not found a definitive link between Benadryl and dementia, the findings do raise a cautionary flag.
- For example, a long-term follow-up study showed that people who took an anticholinergic medication every day for more than 3 years had a significantly higher risk of developing dementia compared to people who did not take them at all. However, the study did not report on individual medications like Benadryl.
- A short-term follow-up study found that people taking anticholinergic medications had signs of brain shrinkage on MRI scans. They also scored lower on mental tests compared to people not taking the medications. These findings point to dementia but dont necessarily mean that the affected people had The study also didnt determine which specific medications were linked to the MRI results and test scores.
Other research studies that looked specifically at antihistamines didnt find an association with dementia.
- For example, a 2019 study found a link between dementia and several classes of anticholinergics used to treat depression, schizophrenia, bipolar disorder, seizures, Parkinsons disease, and overactive bladder. But there was no association between dementia and antihistamine medications.
- A 2018 study had similar findings. While certain types of anticholinergic medications were linked to dementia, antihistamines were not.
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Media Dementia Scare Over Hay Fever And Sleep Drugs
“Hay fever tablets raise risk of Alzheimer’s,” is the main front page news in the Daily Mirror. The Guardian mentions popular brand names such as Nytol, Benadryl, Ditropan and Piriton among the pills studied.
But before you clear out your bathroom medicine cabinet, you might want to consider the facts behind the headlines.
The first thing to realise is although some of these drugs can be bought over the counter , in the US, OTC drugs are typically provided by a private health company. So the study was able to partially track the effects of OTC as well as prescription medication .
These were medicines that have an “anticholinergic” effect, including some antihistamines, antidepressants and drugs for an overactive bladder.
If you have been prescribed these medicines, do not stop taking them without speaking to a doctor first. The harms of stopping might outweigh any potential benefits.
That said, this large, well-designed US study suggested those taking the highest levels of anticholinergic prescribed medicines were at a higher risk of developing dementia compared with those not taking any.
Importantly, the increased risk was only found in people who took these medicines at the equivalent of once every day for more than three years. No link was found at lower levels.
However, this shouldn’t make us complacent. These are not unrealistic doses of medicines, so the results may be applicable to a significant proportion of older adults.
Things To Note About The Research
These studies have important limitations to be aware of.
First, you can buy many antihistamines, including Benadryl, without a prescription. That means its difficult for researchers to know exactly who was and wasnt taking the medications during the studies.
Second, the studies were observational, which means that the associations between dementia and medications might be explained by other factors.
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The research involved data from 3,434 participants ages 65 or older, who had no dementia when the study began. Researchers followed up with participants every two years, from 2004 through September 2012.
According to the findings, the most common anticholinergics used by the subjects were tricyclic antidepressants, like Sinequan, first-generation antihistamines, like Benadryl and Chlor-Trimeton, and bladder antimuscarinics, such as Ditropan.
About 23% of the subjects developed dementia, and most of those that did were also diagnosed with Alzheimers disease. They found that the higher the cumulative use of anticholinergics, the higher the risk for dementia and Alzheimers. with those taking the highest total standardized daily doses facing a 54% increased risk of dementia.
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, Dr. Shelly Gray, the lead study author, said in a press release issued by the university. And they should tell their health care providers about all their over-the-counter use.
Taking Anticholinergics For More Than 3 Years Linked To Higher Dementia Risk
For their study, Prof. Gray and colleagues tracked nearly 3,500 men and women aged 65 and over with no dementia symptoms at the start of the study. The participants were part of the Adult Changes in Thought study in Group Health, an integrated health care delivery system in Seattle.
To assess how much exposure the participants had to anticholinergic drugs, the researchers used computer records from the pharmacies that dispensed them.
From the pharmacy data they added up all the standard daily doses and worked out the cumulative anticholinergic exposure for each participant over the past 10 years. This was updated as participants were followed up for an average of 7 years.
Over the period of the study, nearly 800 participants developed dementia.
The results showed that the most commonly used medications were tricyclic antidepressants , first-generation antihistamines , and antimuscarinics for bladder control .
The researchers estimated that people taking at least 10 mg per day of doxepin, 4 mg per day of chlorpheniramine, or 5 mg per day of oxybutynin for more than 3 years would be at greater risk for developing dementia.
Prof. Gray also told Medical News Today the dose risks associated with Benadryl: The dose of diphenhydramine that would correspond to the highest risk group is taking the equivalent of 50 mg each day for longer than 3 years or 25 mg per day for longer than 6 years in duration.
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Find Out Which Drugs Are Anticholinergic
You may not be familiar with the term anticholinergic when it comes to medication. But this type of pharmaceutical medication is very common, and you might even have some in your home right now. They block the chemical acetylcholine from transmitting messages from nerve cells to other cells of the body, which affects muscle contractions and areas of the brain involved in learning and memory.
Milder anticholinergic drugs include those used to treat gastrointestinal disorders and antihistamines like Benadryl. But those are less worrisome at this point, since they were not found, at least in this study, to raise dementia risk. Cognitive problems, however, were shown to be associated with the longer-term use of stronger forms of anticholinergic medications, such as antidepressants, bladder antimuscarinic drugs, epilepsy medications, and drugs to treat Parkinsons disease symptoms.