OTC Drugs and Dementia
Many commonly used OTC(over the counter drugs) have been linked with dementia(goo.gl/ihYhgc) according to a recent study from the University of Washington
The most commonly used drug linked to dementia was diphenhydramine, which is used in many popular products such as Benadryl, Nytol Sominex, Theraflu, Triaminic Allergy, plus many others. Also implicated where drugs containing chlorpheniramine (Aller-Chlor); oxybutynin (Ditropan) and tolterodine (Detrol) for overactive bladder; and the tricyclic antidepressants, such as doxepin or amitriptyline These drugs share a common feature with other OTC drugs in that they affect levels of acetylcholine(ACh), a common neurotransmitter in the body The short term changes such as confusion and loss of mental clarity are well known to prescribing physicians but the long term consequences and implications of this class of drugs are not recognized
Alzheimer's disease is a one of early senility or poor brain function and is associated with very low levels of acetylcholine(ACh) There is also evidence now that these changes may be irreversible because they produce permanent neurological changes
The relationship to poor brain function and dementia and drugs that control symptoms through lowering levels of ACh should be disturbing to those who rely on this class of drug to control their symptoms whatever they may be
The Study
To evaluate whether cumulative anticholinergic use is associated with a higher risk for incident dementia, researchers examined medical records from 3,434 participants 65 years or older with no dementia at study entry Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003 and data through September 30, 2012 were also included in these analyses
Exposure to anticholinergic was determined from computerized pharmacy records Cumulative exposure was updated as participants were followed up over a 10-year period. About 20% of the population was found to be using anticholinergic drugs
During the evaluation period, 797 participants (23.2%) developed dementia with 637 of these (80%) developing Alzheimer disease A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease. In other words, the higher the cumulative anticholinergic use, the greater the increased risk for dementia The highest risk threshold was taking the minimum daily effective dose of one the anticholinergic agents every day for 3 years
Based upon these results, the authors of the study propose efforts to increase awareness among health care professionals and older adults about the risk of the use of these drugs over time Even at low dosage or recommended levels chronic use of these drugs should be avoided
The Message
It seems self evident that anticholinergic use that is so prevalent in the general population should be kept to a minimum when attempting to reduce symptoms, looking for more alternative ways of managing their symptoms
