More possible links between medication and dementia

When a side effect is only something like a headache or a mild skin reaction, we don’t think much of it. But what ConsumerAffairs found out about the connection between dementia and acid reflux medications may be more than what the Titanic ran into.

A deeper look into what connections possibly exist between certain drugs and dementia or dementia-like effects shows just how chilling that iceberg of issues can be.

It’s important to keep in mind that at present, there’s no evidence conclusive enough to say that there are specific drugs that are directly linked to dementia. 

Nyquil? Benadryl? Sorry to say, but yes.

Despite the lack of conclusive evidence, two of the classes bandied around the most as having a strong link to a risk of dementia are anticholinergics and benzodiazepines. 

Anticholinergics are drugs related to acetylcholine, a chemical in our brains that starts to fade away as we age and, because of that, is used to treat things like urinary incontinence, overactive bladder (OAB), and chronic obstructive pulmonary disorder (COPD). 

In one study, older adults who took the minimum effective dose of anticholinergic medications for at least three years were at highest risk. According to APlaceForMom’s Amanda Lundberg, those drugs include:

• Amitriptyline (Elavil)

• Aripiprazole (Abilify)

• Benztropine (Cogentin)

• Biperiden (Akineton)

• Brompheniramine (Dimaphen DM)

• Carbamazepine (Tegretol)

• Chlorpheniramine (ChlorTrimeton)

• Chlorpromazine (Thorazine)

• Clemastine (Dayhist Allergy)

• Clomipramine (Anafranil)

• Clozapine (Clozaril)

• Cyproheptadine (Periactin)

• Darifenacin (Enablex)

• Desipramine (Norpramin)

• Dexchlorpheniramine (Polmon)

• Dimenhydrinate (Dramamine)

• Diphenhydramine (Benadryl)

• Doxepin (Sinequan)

• Doxylamine (Vicks NyQuil)

• Flupenthixol (Depixol)

• Fluphenazine (Modecate)

• Haloperidol (Haldol)

• Hydroxyzine (Vistaril)

• Imipramine (Tofranil)

• Loxapine (Adasuve)

• Methscopolamine (Pamine)

• Nortriptyline (Aventyl)

• Olanzapine (Zyprexa)

• Oxcarbazepine (Trileptal)

• Oxybutynin (Ditropan)

• Paliperidone (Invega)

• Perphenazine (Trilafon)

• Phenindamine (Nolahist)

• Pimozide (Orap)

• Propantheline (ProBanthine)

• Pyrilamine (Codimal DM)

• Quetiapine (Seroquel)

• Risperidone (Risperdal)

• Solifenacin (Vesicare)

• Thiothixene (Navane)

• Tolterodine (Detrol)

• Trifluoperazine (Stelazine)

• Trihexyphenidyl (Artane)

• Trospium (Sanctura)

• Ziprasidone (Geodon)

• Zuclopenthixol (Clopixol)

Xanax? Ativan? Yep, those, too.

Benzodiazepines, on the other hand, are a class of drugs most often used to treat conditions such as insomnia and panic attack disorder, but can also be prescribed to treat everything from unusual talkativeness to ADHD.

In a study examining the ties between dementia and benzodiazepines, those who took the medication had approximately a 50% increase in the risk of dementia compared with people who never took the medication.

Some benzodiazepines potentially linked to increased dementia risk include:

• Alprazolam (Xanax)

• Chlordiazepoxide (Librium)

• Clonazepam (Klonopin)

• Clorazepate (Tranxene)

• Diazepam (Valium)

• Estazolam (Prosom)

• Flurazepam (Dalmane)

• Lorazepam (Ativan)

• Nitrazepam (Mogadon)

• Oxazepam (Serax)

• Quazepam (Doral)

• Temazepam (Restoril)

• Triazolam (Halcion)

“Although these medications are truly a blessing for some individuals immobilized by anxiety, their use can be accompanied by sedation and mental slowing,” Dr. James M. Ellison, of the Swank Center for Memory Care and Geriatric Consultation, writes. He added that clinicians continue to prescribe anti-anxiety medications such as Ativan and Xanax or sleeping pills such as Restoril and consider them very beneficial when used properly.  

There’s more where these came from

Ellison’s breakdown of medications, in addition to anticholinergics and benzodiazepines, includes drugs that we take for other ailments that “have been shown to cause or are suspected of causing symptoms of dementia.

So, what is someone who takes these drugs supposed to do?

This is where things get sticky. APlaceForMom's Amanda Lundberg says that “in some cases,” a patient may need to continue to take one of these drugs because of its effectiveness, but they should consult with their doctor to ask if a lower dosage or substitute drug that has less of a dementia-like effect would be a safer, smarter way to go. 

“If you’re uncertain about your loved one’s exposure to drugs linked to dementia, bring all their medications to their next doctor’s appointment,” she said. 

“A geriatrician, with expertise in age-related issues, will be able to provide valuable insight into your loved one’s medication regimen, thus increasing their health and safety. Remember that it’s always better to use caution when it comes to dementia-linked medications.”