Dementia

When asked about the medical conditions they fear the most, adults overwhelmingly answer dementia, specifically Alzheimers dementia. Treatment options for dementia are dismal, so the focus needs to be on prevention. Many risk factors for dementia are things you can control: diabetes, high blood pressure, physical inactivity and even some medications.

Multiple studies have found an association between the use of certain medication classes with dementia and cognitive (thinking, understanding, learning, remembering) impairment in older adults. For the medications on this list, the effects are worse at higher doses taken for extended periods of time. Most of these cognitive effects can be resolved if you stop the medication, but there is a chance that some may not.

In any case, if a medication can impact your mind long term, you should know. If you are taking any of the following medications, you might want to consider talking with your doctor about your risk for cognitive impairment and dementia.

Anticholinergics

  • What do we know? The anticholinergic drugs that may impact the mind are tricyclic antidepressants, antihistamines, and overactive bladder medications. In a sample of adults, high doses of these medications were associated with an increased risk of dementia. Other studies have shown that the use of an anticholinergic medication was associated with brain atrophy and clinical decline.
  • What meds are we talking about?
    • Antihistamines like allergy medications. Over the counter allergy medications, called antihistamines, have anticholinergic properties that may increase the risk of dementia. Examples include Chlor TrimetonBenadrylChlor-tab, and Aller-Chlor
    • Sleep meds containing the active ingredient of Benadryldiphenhydramine—like Sominex, Unisom, Advil PM, Aleve PM, and Tylenol PM.
    • Tricyclic antidepressants like doxepin (Silenor), nortriptyline, and amitriptyline.
    • Irritable bowel syndrome medications used for abdominal pain like hyoscyamine (Levsin) and dicyclomine (Bentyl).
    • Overactive bladder medications like Enablex, Ditropan, Detrol, Sanctura, and Vesicare. This also includes medications used for large prostate and bladder symptoms like Toviaz. 

Proton pump inhibitors

  • What do we know? Studies suggest that men and women with dementia were 1.5 and 1.4 times more likely, respectively, to be taking proton pump inhibitors (PPIs). PPIs may cause accumulation of β-amyloid plaques. Malabsorbtion of vitamin B12 or other nutrients due to long-term PPI use could also play a role.
  • What meds are we talking about? 
    • Omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium)and pantoprazole (Protonix) are examples of proton pump inhibitors that can increase the risk for cognitive impairment and dementia, and have been in the news lately for this potential risk.

Opioid pain medications

  • What do we know? Studies show a slightly higher dementia risk in people with heavy long-term use of opioid medications.
  • What meds are we talking about?
    • Morphine, hydrocodone (Vicodin), hydromorphone (Diladud) and fentanyl are examples of opioids that can increase risk for dementia.

Atypical benzodiazepines/insomnia meds

  • What do we know? Insomnia medications, specifically ones that are part of the atypical benzodiazepines class, have been found to be associated with increased risk for dementia in the elderly population. Higher cumulative doses might even carry a bigger risk of developing dementia.
  • What meds are we talking about?
    • Ambien (zolpidem), Sonata (zaleplon) and Lunesta (eszopiclone) are examples of insomnia meds in the atypical benzodiazepine class that can increase risk.

To those suffering from dementia, or caring for a loved one who is, we are with you.

 

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