Key Takeaways
- There isn’t definitive evidence for a list of drugs linked to dementia. However, some medications are linked to dementia risk, and many doctors advise against prescribing these to seniors.
- Studies suggest a strong link between anticholinergic drugs and increased risk of dementia. Anticholinergics include antidepressants, antipsychotics, and some bladder control medications.
- Benzodiazepines, antihistamines, and sleep medications are also implicated. When people use these drugs long-term and in high doses, studies show they can elevate dementia risk.
- Instead of medications, alternative treatments or reduced doses could lessen dementia risks. Include a geriatrician in medication decisions to boost safety.
What prescription drugs are linked to dementia?
Despitea lack of clear causation, it’s observed that memory loss is a side effect of the following types of drugs. Because of this, the American Geriatrics Society and numerous studies advise against prescribing these medications to seniors whenever possible:[01]
- Anticholinergics
- Antidepressants
- Antipsychotics
- Benzodiazepines
- Antiepileptic drugs
- Antihistamines
- Incontinence drugs
- Sleep aids
- Antimuscarinics
- Chemotherapy drugs
- Corticosteroids
- Diphenhydramine
- High blood pressure medications
- Motion sickness medications
- Pain medications
- Statins
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A list of anticholinergic drugs linked to dementia
Anticholinergics are a class of medications that block the activity of a vital neurotransmitter called acetylcholine.[02] These drugs are associated with significant increases in dementia risk. This list includes certain antidepressants, antiparkinsonians, antipsychotics, antiepileptic drugs, and medications for bladder control:
- 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)
According to a study in theJournal of American Medical Association, adults aged 55 and older were nearly 50% more likely to develop dementia if they took just one anticholinergic daily for three years.[03] Additionally, other studies that link anticholinergics to dementia have found that common over-the-counter antihistamines, such as Benadryl and Vicks NyQuil, are linked with higher rates of dementia.[04]
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A list of benzodiazepine drugs linked to dementia
Benzodiazepines are a class of medications often prescribed to seniors for anxiety and insomnia, according to the U.S. Department of Justice Drug Enforcement Administration. Various studies, including one from theJournal of Clinical Neurology,highlight a substantial rise in dementia risk while taking the following types of benzodiazepines:
- 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)
This risk appears to be more pronounced for individuals who took higher doses of benzodiazepines for extended durations.[05]
If you’re helping a loved onemanage any of these medications, it’s worth conversing with their doctor. Discuss balancing the benefits of these drugs against the potential risk of dementia. Understanding what prescription drugs affect dementia could lead to safer medication choices, particularly for our vulnerable seniors.
Why certain drugs have a strong effect in older people
Due to physiological changes associated with aging, certain medications can affect older adults differently. The following physiological and lifestyle factors mean that older adults often require different dosing regimens andcareful monitoringwhen using these medications to minimize the risk of adverse effects.
Slower metabolism
The liver is the primary organ responsible for metabolizing medications. As people age, liver function declines, leading to slower drug metabolism. Medications may stay in the body longer, increasing the risk of side effects or toxicity.
Changes in body composition
Older adults generally have a higher body fat percentage and lower muscle mass. Fat-soluble (lipophilic) medications, such as certain sedatives or antidepressants, may accumulate in this increased fat tissue. This accumulation can lead to a prolonged half-life, meaning the drugs stay in the body longer. They may also be released slowly, potentially causing prolonged effects or toxicity.
Altered drug receptor sensitivity
Aging can affect the number and sensitivity of receptors for various medications, leading to increased or decreased effectiveness and changes in side effects.
Increased sensitivity to central nervous system (CNS) drugs
The central nervous system becomes more sensitive with age, making older adults more susceptible to the effects of medications that act on the brain, such as anticholinergics, antidepressants, and benzodiazepines.
Liver function decline
The liver is crucial for metabolizing medications. Aging can reduce the liver’s size and blood flow, slowing down the enzyme activity that breaks down drugsand making medications linger longer in the system.
Decreased kidney function
The kidneys are crucial for excreting medications. With age, kidney function typically declines, resulting in slower drug clearance. This can cause medication to accumulate in the body, leading to potential toxicity.
Reduced protein binding
Older adults often have lower levels of serum albumin and other proteins. Many medications bind to proteins in the bloodstream. With fewer binding proteins available, the amount of unbound, active drug can increase, potentially intensifying its effects.
Comorbidities and polypharmacy
Older adults are more likely to have multiple chronic health conditions and take several medications simultaneously, which increases the risk of drug interactions and adverse effects.
Chemotherapy drugs and dementia
“Chemo brain,” which has symptoms similar to dementia, is a term referring to cognitive and memory problems associated with cancer and chemotherapy treatments. Despite the similarities, chemo brain is typically reversible once a patient’s health improves, unlike dementia.
While dementia and chemo brain both result in memory loss, they are different in many ways. Dementia leads to gradual cognitive changes and is incurable. Chemo brain, on the other hand, is directly linked to cancer or its treatment and often improves over time. Notably, people with chemo brain are typically aware of their memory lapses and can recall memories with prompting, which isn’t the case for dementia patients. Additionally, chemo brain doesn’t typically affect speech patterns or lead to hallucinations and wandering, which are common dementia symptoms.
More research is still needed to confirm the link between chemotherapy and dementia. However, some studies do suggest that chemotherapy treatment could lead to cognitive decline and potential dementia.[06] Factors such as a patient’s age, sex, weight, diet, chronic inflammation, types of chemotherapy, and type of cancer can all significantly influence these results. For elderly patients who are more susceptible to chemotherapy-related toxicities, chemotherapy can potentially affect their quality of life.
Read more:Chemo Brain and Dementia: What’s the Connection?
Read more:Chemo Brain and Dementia: What’s the Connection?
How to minimize medication-induced dementia risk
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 for review. Remember to include over-the-counter (OTC) drugs and prescriptions. Remember that a geriatric-specialized doctor (geriatrician) can provide valuable insight into your loved one’s medication regimen, thus increasing their health and safety. They can offer information on alternative treatments safer for seniors than the above drugs, which a general practitioner may be unfamiliar with.
