Study: Anticholinergics (Benadryl, Tylenol PM, Antidepressants) Linked To Dementia

Dementia3This new study is adding to the body of evidence that drugs called anticholinergics (ACs, they block the neurotransmitter acetylcholine) are associated with cognitive impairment and dementia:

Association Between Anticholinergic Medication Use And Cognition, Brain Metabolism, And Brain Atrophy In Cognitively Normal Older Adults, JAMA Neurology, Online 18 April 2016

They didn’t measure the amount they were taking, just that they were taking an anticholinergic drug (see list below). Those who took at least one AC had changes in brain structure:

Reduced total cortical volume and temporal lobe cortical thickness and greater lateral ventricle and inferior lateral ventricle volumes were seen in the AC+ participants relative to the AC− participants.

Those who took at least one AC also showed lower measures for memory, had more difficulty processing information, and showed other measure of cognitive decline.

Conclusions and Relevance: The use of AC medication was associated with increased brain atrophy and dysfunction and clinical decline. Thus, use of AC medication among older adults should likely be discouraged if alternative therapies are available.

Lead author Shannon Risacher, Ph.D said:

“We did see the risk heighten in the person who took more than one kind of anticholinergic.”

What’s an anticholinergic drug? There are lots of them. I picked this list up from VirginiaGeriatrics.org:

Commonly used drugs with moderate to high anticholinergic properties:

Antiarrythmics:
Disopyramide – Norpace®
Procainamide – Pronestyl®
Quinidine – Quinaglute®, Quinidex®

Antiemetics:
Dimenhydrinate – Dramamine®
Meclizine – Antivert®, Bonine®
Trimethobenzamide – Tigan®
Prochlorperazine -Compazine®

Antihistamines:
Azatadine – Optimine®
Chlorpheniramine – Chlor-Trimeton®
Clemastine – Tavist®
Diphenhydramine – Tylenol PM®, Sominex®, Benadryl®
Hydroxyzine – Atarax®, Vistaril®
Promethazine – Phenergan®

Antiparkinson Agents:
Benztropine – Cogentin®
Biperiden – Akineton®
Procyclidine – Kemadrin®
Trihexyphenidyl – Artane®

Antipsychotics:
Chlorpromazine – Thorazine®
Clozapine – Clozaril®
Mesoridazine – Serentil®
Olanzapine – Zyprexa®
Promazine – Sparine®
Quetiapine – Seroquel®
Thioridazine – Mellaril®

Antispasmotics:
Atropine – Sal-Tropine®
Belladonna alkaloids – Donnatal®, Bellatal®, Barbidonna®
Dicyclomine – Antispas®, Bentyl®
Flavoxate – Urispas®
Hyoscyamine – Anaspaz®, Levbid®, Cystospaz®, Levsin/SL®
Oxybutynin – Ditropan®
Scopolamine
Tolterodine – Detrol®

Skeletal muscle relaxants:
Carisoprodal – Soma®
Chlorzoxazone – Parafon®, Forte®
Cyclobenzaprine – Flexeril®
Methocarbamol – Robaxin®
Orphenadrine – Norflex®

Tricyclic Antidepressants:
Amitriptyline – Elavil®
Desipramine – Norpramin®
Doxepin – Sinequan®
Imipramine – Tofranil®
Nortriptyline -Aventyl®, Pamelor®

It’s not an exhaustive list. There are more antidepressants, sleep aids, drugs for asthma and chronic bronchitis, antacids like Zantac, even eye drops like Atropine used to dilate pupils.

One thought on “Study: Anticholinergics (Benadryl, Tylenol PM, Antidepressants) Linked To Dementia

  1. Bix Post author

    To use Marj’s word here … I feel a sense of powerlessness, and of anger and frustration, when I see people’s brains, good sharp brains, slowly erode because of drugs. Whether it’s alcohol or street drugs or even drugs that, like here, may be helping in one way but hurting in another. It’s heartbreaking.

    Reply

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