Common class of drugs linked to increased risk of Alzheimer's disease

[Klaralven]

A team of scientists, led by researchers at University of California San Diego School of Medicine, report that a class of drugs used for a broad array of conditions, from allergies and colds to hypertension and urinary incontinence, may be associated with an increased risk of cognitive decline, particularly in older adults at greater risk for Alzheimer's disease (AD).

The findings were published in the September 2, 2020 online issue of Neurology, the medical journal of the American Academy of Neurology.

Anticholinergic drugs are widely used for dozens of conditions, minor and major. Some of these medications require a prescription, while others can be purchased over the counter. They work by blocking acetylcholine -- a type of neurotransmitter or chemical messenger known to be critical for memory function -- from binding to receptors on certain nerve cells. The effect is to inhibit parasympathetic nerve impulses, which are involved in a variety of involuntary muscle movements, such as those in the gastrointestinal tract and lungs, and bodily functions like salivation, digestion and urination.

Researchers reported that cognitively normal study participants who were taking at least one anticholinergic drug at baseline were 47 percent more likely to develop mild cognitive impairment (MCI), often a precursor to dementia such as AD, while being tracked over a period of up to a decade compared to participants who did not take such drugs.

https://www.sciencedaily.com/releases/2020/09/200904125116.htm

https://www.theseniorlist.com/medication/anticholinergic-drugs/

[hlthe2b]

1. I honestly think anyone--especially if older who is on multiple drugs for multiple conditions needs

to have a pharmacist THOROUGHLY review all the meds they are on (and sorry, young pharmacists that seem to rely ONLY on the computer to do this, but I'd go to a couple of pharmacists, including at least one older, experienced "old school" pharmacist to do this). AND, don't assume your physician is remaining cognizant of ALL the medications you are on and potential issues. Write out a list, with doses, and how long you have been on them--along with any nutritional or herbal supplements-- and show them to both pharmacist and physician/PA. Do it at least annually.

As for the pharmacist review, go at OFF-HOURS when they are not busy.

[neeksgeek]

9. +1000!

Seriously. This is just a personal experience, but a psychiatrist who had my medical history prescribed a drug for me, that actually has a known interaction with a drug I’d been on previously. It’s in the literature, “do not prescribe drug B if patient has ever been on drug A, due to a rare but potentially deadly side effect.” I at that time wasn’t quite paranoid enough to check these things. And when the first signs of that rare side effect (full body rash looking remarkably like smallpox) did show up because of course they did, my doctor insisted it wasn’t possible and I was imagining it. Luckily I went of the med immediately and found a new doctor. They’re doctors, not demigods, and they can and do make mistakes.

[womanofthehills]

17. As you get older, drugs also stay in your body longer because

Your detoxification system is slower. When a dr doubled my mother’s blood pressure med, she became temporarily psychotic until taken off and then she was normal again Her blood pressure was just borderline - not even high. . I never trust doctors and drugs -it’s so easy to research everything now. My favorite site to research side effects is “ask a patient”.

[still_one]

2. This seem to run counter to previous studies where Aricept, a Cholinesterase Inhibitor is used

to treat severe dementia, and has been shown to slow down the progression of Alzheimer

It also presents a problem for those who have diseases such as myasthenia gravis who are routinely given anticholinergic drugs

I notice that mestinon/pyridostigmine which are Acetylcholinesterase inhibitors are not listed

[Mike 03]

5. Actually, Aricept increases acetylcholine by destroying the enzyme that

destroys acetylcholine. It is a bit confusing. Aricept is an acetylcholinesterase inhibitor.

Donepezil inhibits acetylcholinesterase, an enzyme responsible for the destruction of one neurotransmitter, acetylcholine. This leads to increased concentrations of acetylcholine in the brain, and the increased concentrations are believed to be responsible for the improvement seen during treatment with donepezil.

https://www.medicinenet.com/donepezil/article.htm

[still_one]

7. You are absolutely right, it is a cholinesterase inhibitor, the exact opposite of anticholinergic

class of drugs, and may add to the mental deterioration noted with those being treated for Parkinson with anticholinergic drugs alongside other drugs


Thanks

[brewens]

3. I sure picked the right year to lose a bunch of weight and get off several meds.

It took two years actually, but I'm down over 140 and at my high school senior weight of 215. Last BP was 117/72 and I'm 59. Getting ready to go out for my daily three mile walk.

[Lochloosa]

8. Congrats!

[reACTIONary]

14. Super! +100

[fierywoman]

15. BRAVO !!!

[Mike 03]

4. This study actually corroborates earlier studies:

From May 2016:

Common Meds and Dementia: How Strong Is the Link?

How do the drugs affect the brain and how do they boost dementia risk?

"They reduce the activity of, or block, acetylcholine," Risacher says. "It is very important for memory."

While some drugs used to treat Alzheimer's work by increasing the amount of acetylcholine to improve memory, she says, "these drugs essentially do the opposite."

https://www.webmd.com/allergies/news/20160509/anticholinergic-drugs-dementia-link#1

[Buckeye_Democrat]

6. OMG... Claritin!

My oldest brother has dementia, and he's my only sibling who has it despite how he's not even the oldest sibling (sisters).

He's also the only sibling who took Claritin for YEARS because of allergies, claiming it was the only one that helped alleviate the symptoms without making him too drowsy.

Edit: And the irony is that he tried to avoid medications whenever possible, and he was the biggest health-nut in our family -- exercising every day, staying thin, eating a variety of healthy foods, etc.

[PatSeg]

11. It is appears that Claritin

is not an anticholinergic drug, but Benedryl is.

And when it comes to allergies, there are many alternatives to Benadryl, an anticholinergic and so-called first generation antihistamine. Second- and third-generation antihistamines, including brands such as Claritin, Zyrtec and Allegra, are not anticholinergics.

https://www.cbsnews.com/news/popular-drugs-for-colds-allergies-linked-to-dementia/#:~:text=And%20when%20it%20comes%20to,switching%20to%20a%20new%20drug.

I finally stopped taking Benedryl, as I suffered horrible restless leg syndrome when I took it and that condition is often caused by blocking the neurotransmitter dopamine.

[ecstatic]

13. Wow. Thanks.

I've noticed a decline in my own functioning. I guess it's time to quit. Cold turkey. 😩

[PatSeg]

18. I take it once in a rare while

but there have been times in the past when I was taking it every day. If a person has a sudden allergic reaction to something, Benedryl can be a lifesaver, but apparently its not a good idea to take it on a regular basis.

[Buckeye_Democrat]

24. Thanks for your replies!

I wonder why that previous link listed Claritin as being linked to dementia?

My brother took other allergy drugs for years too, but he pretty much stuck to Claritin soon after it was on the market.

He hated how Benadryl made him feel, often feeling even more tired after he slept on it. **

I had hives the only time in my life after a bad case of stomach flu, and they lingered on and on. Benadryl was the only anti-histamine drug that helped me! So it's indeed not all bad.

I have a few allergies, but not even close to what my oldest brother went through.

** Side-story:
Me and my brother watched Ohio State play Northwestern in 2002, and my brother had heard Maurice Clarett (OSU running back) say he was going to knock himself out for the flight there with Benadryl. My brother kept harping that he'd probably be super-groggy from it, and then he kept yelling about it as Clarett repeatedly fumbled and acted unusually lethargic. So much so that he was removed from the game! Lol.

[PatSeg]

26. I've never found any medication as effective

for allergies as Benedryl. It is the only one where the effects are clearly noticeable, but I know now to take it sparingly.

Interesting side story! I do know people who get very drowsy when they take Benedryl so I can see where that would be possible.

[Buckeye_Democrat]

29. It helped me immediately when I had hives.

I tried all kinds of stuff which never helped, and I put off trying Benadryl because of my brother's repeated warnings about it.

It was so weird to me how those red itchy spots would disappear from one part of my body only to appear elsewhere soon thereafter. So thankful that Benadryl finally put an end to it!

As for the side-story, Clarett was put back in the game later and he played more like his usual self in the 2nd half.

[reACTIONary]

16. Thanks! I just stocked up on Claritin ...

... thought for a second there I was going to have to flush twenty bucks.

[PatSeg]

19. I take Claritin occasionally

though I never found it as effective as Benedryl. I think the thing to remember is any drug taken daily over a long period of time could have long term side effects, but occasional usage is often harmless. And of course every medication affects different people differently.

[reACTIONary]

27. My spouse takes Claritan regularly...

... She needs it. I take Benadryl, only occasionally, because it seems much more effective. An occasional dose isn't going to have any long term effects.

[PatSeg]

32. Oh I agree

and I think it is a good idea to have Benedryl in the house for allergic reactions.

[bucolic_frolic]

10. Not surprising

I read an alt book in the 1990s, can't remember it's name or author, it was a library book, that said there could be residual amounts of mercury in many medications. Might have been Hal Huggins book, or another author.

Dementia literature sometimes warns against aluminum cookware for the metal content, and against baking powder with aluminum, and against high fructose corn syrup. And of course to avoid any hint of mercury.

At one time I was told some molasses contained mercury, but they've changes the processes now.

[Ligyron]

12. When I stopped taking diphenhydramine on a regular basis, I quit stammering.

Like immediately. I had been taking it for sleep in high doses too and I only started sputtering for words about a year ago when an instant verbal response was required during a semi stressful situation .

I had heard about the issue with diphenhydramine awhile ago and while I have no idea if the 2 are linked or if ceasing to use it could produce such an instant effect, that did happen.

[PatSeg]

20. That's incredible

You are fortunate to have figured it out.

[ananda]

21. Here's a list. It includes Benadryl (diphenhydramine)

https://www.healthline.com/health/anticholinergics#warnings

[Roland99]

28. Thanks! So, except for Benadryl, it's prescription meds, not OTC

List of anticholinergics

Anticholinergics are only available with a doctor’s prescription. Examples of these drugs include:

atropine (Atropen)
belladonna alkaloids
benztropine mesylate (Cogentin)
clidinium
cyclopentolate (Cyclogyl)
darifenacin (Enablex)
dicylomine
fesoterodine (Toviaz)
flavoxate (Urispas)
glycopyrrolate
homatropine hydrobromide
hyoscyamine (Levsinex)
ipratropium (Atrovent)
orphenadrine
oxybutynin (Ditropan XL)
propantheline (Pro-banthine)
scopolamine
methscopolamine
solifenacin (VESIcare)
tiotropium (Spiriva)
tolterodine (Detrol)
trihexyphenidyl
trospium

Although classified as an antihistamine to be taken for allergies and as a sleep aid, diphenhydramine (Benadryl) also has anticholinergic effects.

[Ferrets are Cool]

22. Here come the tv commercials. "If you took " " between the years of "such and such"

and have, or know someone who has Alzheimers Disease, please call us. You may be entitled to compensation."

[onlyadream]

23. This includes sleep aids that contain Diphenhydramine, as well as benadryl

Which really stinks because I often use the sleep aids.

[OregonBlue]

25. List of anticholinergic drugs from Healthline

atropine (Atropen)
belladonna alkaloids
benztropine mesylate (Cogentin)
clidinium
cyclopentolate (Cyclogyl)
darifenacin (Enablex)
dicylomine
fesoterodine (Toviaz)
flavoxate (Urispas)
glycopyrrolate
homatropine hydrobromide
hyoscyamine (Levsinex)
ipratropium (Atrovent)
orphenadrine
oxybutynin (Ditropan XL)
propantheline (Pro-banthine)
scopolamine
methscopolamine
solifenacin (VESIcare)
tiotropium (Spiriva)
tolterodine (Detrol)
trihexyphenidyl
trospium
Although classified as an antihistamine to be taken for allergies and as a sleep aid, diphenhydramine (Benadryl) also has anticholinergic effects.

[PoindexterOglethorpe]

30. Somehow this isn't too surprising.

I am frequently surprised at how many prescription meds a lot of people take. And if you're taking one medicine to correct side effects of another medicine, you are probably taking at least one medicine too many.

[crickets]

31. Thank you, Klaralven.

I was recently prescribed one of the drugs on the list. I do notice some issues and I'm going to need to discuss it with my doctor and rethink some alternatives. The issues I'm having may be unrelated, but why take a chance if there are other drugs available for treatment? Thank you so much! You likely just helped a bunch of people by sharing this information.