As many as a third of people over 65 take anticholinergic drugs—shown to increase risk for dementia, including Alzheimer’s–significantly. But most don’t know it.
These drugs do have short term benefits, but many people do not even know that they are anti-cholinergic drugs. For an excellent guide, see Are Your Prescriptions Killing You? by pharmacologists Neel and Hogan.
A study in JAMA Internal Medicine last month called Cumulative Use of Strong Anticholinergics and Incident Dementia recounts how they work: they interfere with the ability of a crucial brain chemical called acetylcholine (Ach) to attach to nerve cells. How that can bring dementia is unknown.
As an example, those taking at least 10 mg/day of doxepin, 4 mg/day of chlorpheniramine, or 5 mg/day of oxybutynin for more than three years would be at greater risk for developing dementia.
Other such medications that are commonly prescribed include Benadryl, Sominex, Xanax, Ativan, Valium, Luminal, Skelaxin, Limbitrol, and Tavist. Here is a list of antihistamines to avoid from UCSF. All of these and more are in Neel and Hogan.
The authors wrote “Older adults should be aware that many medications—including some available without a prescription, such as over-the-counter sleep aids—have strong anticholinergic effects.”
Here is a comprehensive list of common anti-cholinergic drugs for which you should either find a substitute (with your doctor’s guidance) or take the lowest dose you can for the shortest time (ditto). It’s from People’s Pharmacy, which is smart, reliable and up to date.
Even better, find out whether what and how you eat and live can change your need for that medication–for good.