A new study in the University of Washington provides strong evidence that certain popular drugs may increase the risk of dementia in older adults. The drugs share some common mechanisms within key areas of the brain but are used primarily as ingredients in over-the-counter sleep, cough, cold, and allergy medicines as well as in the treatment of an overactive bladder and depression.
Drugs And Dementia
The most commonly used drug linked to dementia is diphenhydramine, which is used in many popular products such as Benadryl, Nytol Sominex, Theraflu, Triaminic Allergy, etc. It is also implicated in drugs containing chlorpheniramine (Aller-Chlor); oxybutynin (Ditropan) and tolterodine (Detrol) for overactive bladder; and tricyclic antidepressants, such as doxepin or amitriptyline.1
Acetylcholine is a critical brain chemical involved in the transmission of nerve impulse and is especially important for proper memory and cognitive function. For example, Alzheimer’s disease is associated with a severe reduction in acetylcholine levels due to reduced activity of the enzyme that manufactures acetylcholine (choline acetyltransferase).2
Given the link between low acetylcholine levels and poor brain function, including dementia, previous studies have linked drugs to reduced acetylcholine activity as well as mild cognitive impairment. These drugs include the ones mentioned earlier.
While discontinuation of the drugs is thought to reverse the mental deficit, there is evidence that anticholinergic drugs may produce permanent changes leading to irreversible dementia.
These drugs are known to cause short-term drowsiness or confusion, which is included in the prescribing information, but the long-term effects these drugs have on mental function are generally not known by physicians or the people taking them.3 4 5
Other drugs, like sedative hypnotic drugs (sleeping pills) and antihistamines, have also been linked to an increased risk of dementia. All of these drugs, both prescription and over-the-counter, are used at an alarming rate by the elderly population, putting them at significant risk for dementia.
To evaluate whether cumulative anticholinergic use is associated with a higher risk of incident dementia, researchers examined medical records from 3,434 participants 65 years or older with no dementia at study entry. Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003 and data through September 30, 2012 were also included in these analyses.6
Exposure to anticholinergic drugs was determined from computerized pharmacy records. Cumulative exposure was updated as participants were followed up over a 10-year period. About 20% of the population was found to be using anticholinergic drugs.
During the evaluation period, 797 participants (23.2%) developed dementia, with 637 of these (80%) developing Alzheimer’s disease. A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer’s. In other words, the higher the cumulative anticholinergic use, the greater the risk of dementia. The highest risk threshold was taking the minimum daily effective dose of one of the anticholinergic agents every day for 3 years.
Even at low dosage or recommended levels, chronic use of these drugs should be avoided.
Based upon these results, the authors of the study propose efforts to increase awareness among health care professionals and older adults about the risk of the use of these drugs over time.
The results from this study highlight the importance of avoiding long-term use of such drugs, including diphenhydramine and over-the-counter sleeping pills. What this research further establishes is that the human brain can be adversely affected by minor pharmacological agents, highlighting the importance of using natural approaches that not only address the key issue (e.g., insomnia, allergies, etc.) but also have a positive effect on brain function. For example, the natural compound enzymatically modified isoquercitrin (EMIQ) has demonstrated significant anti-allergy effects and also has been shown to block the formation of beta-amyloid, a protein that is linked to causing the brain damage in Alzheimer’s disease.
References [ + ]
|1.||↑||Basu, Ranita, Hiroko Dodge, Gary P. Stoehr, and Mary Ganguli. “Sedative-hypnotic use of diphenhydramine in a rural, older adult, community-based cohort: effects on cognition.” The American journal of geriatric psychiatry 11, no. 2 (2003): 205-213.|
|2.||↑||Richter, Judith A., Elaine K. Perry, and Bernard E. Tomlinson. “Acetylcholine and choline levels in post-mortem human brain tissue: preliminary observations in Alzheimer’s disease.” Life sciences 26, no. 20 (1980): 1683-1689.|
|3.||↑||Starr, John M., and Lawrence J. Whalley. “Drug-induced dementia.” Drug safety 11, no. 5 (1994): 310-317.|
|4.||↑||Ancelin, Marie L., Sylvaine Artero, Florence Portet, Anne-Marie Dupuy, Jacques Touchon, and Karen Ritchie. “Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study.” Bmj 332, no. 7539 (2006): 455-459.|
|5.||↑||Mintzer, Jacobo, and Alistair Burns. “Anticholinergic side-effects of drugs in elderly people.” Journal of the Royal Society of Medicine 93, no. 9 (2000): 457.|
|6.||↑||Gray, Shelly L., Sascha Dublin, Onchee Yu, Rod Walker, Melissa Anderson, Rebecca A. Hubbard, Paul K. Crane, and Eric B. Larson. “Benzodiazepine use and risk of incident dementia or cognitive decline: prospective population based study.” bmj 352 (2016): i90.|
Yep, heard this from my mom's doctor about Benedryl. Good to know if you're older and having trouble sleeping, not your best choice on a regular basis
Starting to worry I am on 3 a day Amitriptyline a day for nerve pain in my hands has been on that for couple of years i am nearly 63 years old think a visit to doctor to speak about this but they claim that pill only one that will help.
If this had been proven beyond any doubt, after multiple long controlled trials, the medications would become prescription only or withdrawn from sale indefinitely.
You are right Barbara Anthony, but the problem is people don't know there are natural alternatives to OTC and pharmaceuticals, so they just keep taking them.
Sleep deprivation and anxiety left me no alternative but to use Diphenhydramine for almost 30 years. Add fibromyalgia 10 years ago (Lyrica}, and an autoimmune disease and condition horrible painful and itchy blisters for which I was prescribed a very potent drug, Dapsone.. Dapsone is a very potent drug also used to treat leprosy. So it is also an antibacterial drug. Dapsone is also used at times as an organ transplant. It is very toxic. I had no alternative. As an aside to Lyrica which has the added non benefit of peripheral neuropathy. Lucky me. Please bury me sooner rather than later.
@piezdescalzos That sounds terrible and very familiar to people who found out after years and numerous doctors that they had one or more tick diseases. Please see the lyme disease documentary and look at ilads. org or talk to people in Lyme groups. There are numerous tick diseases and they don't have a good test or any test for them.
See a homeopath! Homeopathy works by reversing the damages from one med back to the damage from the previous med and so on back to the original reason you started meds.I was raised in a full on allopathic mileu with a physician father, med tech brother, RN sister...went pre-med, nursing school myself working in medicine 25 yrs then medical model mental health for another 25. Homeopathic medicine still rocks my empirical credulity but I see it working & that evidentiary enough. Meds very low cost & safe.
Yeah, I can either constantly sneeze and have other allergy symptoms for 6 months of the year, or I can rot my brain. I can't say I disbelieve you, but I disbelieve you.
@AndrewDiseker It was good they referred to at least one natural remedy. Quercetin may help and there are others, look or ask around for natural products for allergies. Vitamin C and ashwagandha may be two others. Allergy shots?
If you are not willing to cite the actual work, post a link to the paper or give contact information to the researchers, then you are misinformed, misinterpreting, have other gains in mind, a liar, a damned liar, a politician or a quack.
@JimMataczynski I went to google, and typed in "benedryl dementia". I know I had heard about this before. https://www.google.com/search?q=benedryl+dementia&oq=benedryl+dementia&aqs=chrome..69i57j0l5.3583j0j7&sourceid=chrome&ie=UTF-8
Where are the references/work sited information to this research? Nothing like instilling fearinto people that normally do not know what to look for as a means of "proof" to this information. Garbage. Shame on you.
@SarahLoftin Would've been nice if they did. But a quick google search gives information, like this one http://archinte.jamanetwork.com/article.aspx?articleid=2091745
All we will need comes right out of the ground. Quest: why treat the symptoms & not the root cause. Ans: money & lack of courage.