News headlines grabbed the attention of many in the past few days with the findings that anticholinergic medications may lead to dementia. The study published June 24, 2019 in Journal of the American Medical Association (JAMA) Internal Medicine ignited a flurry of media reports.
Anticholinergics are a common group of medications such as certain antidepressants, bladder control, antiseizure meds, antipsychotics, allergy meds, and others. Strong evidence identified dementia risk with many medications in this drug class.
If you are on medications, you must not dismiss this information. Today’s concerns require you to be an active participant. Know what drugs you or your family members take and then be vigilant about protection from adverse drugs risks.
Due to the growing epidemic of dementia, scientists have tried to identify as many modifiable risk factors that increase Alzheimer’s risk. Adverse drug effects are one of those risk factors. The goal of the JAMA study was to further explore if certain types of anticholinergic medications increase the risk of dementia in a very large population study.
Short-term adverse effect of anticholinergic medications causing confusion and memory loss has been known for many years. The bigger concern is long-term adverse effects. This study found somber risks for long-term medication users.
The nested-control study completed in England involved 284,343 of middle age to senior participants who used anticholinergic medication for an extended time and controls who did not use any of the meds. Participants’ prescription information was evaluated for up to 20 years.
Results showed nearly 50 percent increased odds of dementia before the age of 80 when strong anticholinergic type drugs were used for 1,095 or more days during a 10-year period. This amount of time is equivalent to using one minimum dose every day for three years. The adverse drug risk was viewed as much or more of a risk factor as diabetes, hypertension, smoking, and sedentary lifestyle. The findings were viewed as an “association” not a “causation”.
Those who took less powerful anticholinergic medications had a higher risk and diagnosis of dementia compared to those who did not use any anticholinergic medications. The greatest risks were found in people younger than 80 years of age. The drugs with the greatest association were antidepressants, antipsychotics, bladder antimuscarinics/over-active bladder, antiparkinson, and antiseizure/antiepileptics medications.
There are many other anticholinergic medications used for allergies, bronchodilators, antivertigo/antinausea, antiarrhythmic, antispasmodic GI drugs, and muscle relaxers.
Common anticholinergic drug names include Benadryl, Anafranil, Cogentin, Zyprexa, Seroquel, Ditropan, Vesicare, Detrol, Elavil, Asendia, Tofranil, Pamelor, Zanaflex, Robaxin, Scopalamine, Bentyl, Immodium, Spiriva, and Atrovent. There are many others. Check with your pharmacist to see if your medication is an anticholinergic medication and if there are alternatives.
In response to this article, scientists and medical professionals urge patients to not discontinue their medication abruptly. They encourage patients to talk with their providers to find safer options with less risky anticholinergics, other types of meds that are not anticholinergics or to use nonpharmacological treatments when possible.
Think about this for a moment. Anticholinergic medications block the neurotransmitter acetylcholine in the central and the peripheral nervous system. If you block something that plays such a profound role in the nervous system, it is likely to create a wave of dysfunction and backlog of unmet needs. You end up relying on your reserves or other back-up resources, but inevitably there is a toll to the outcome. This is especially true with a chronic challenge or something has a high demand. In terms of choline, the brain and peripheral nervous system have a high demand for it and many individuals do not get enough choline in their diet.
Like other medications, the longer you are on a strong anticholinergic drug, the greater the adverse risks. I encourage you to think critically about benefits and risks with these types of concerns. More importantly, consider ways to help nutritionally fortify your brain if you are in this circumstance. Here are some important resources to utilize.