The headline “7 medications that cause severe dementia and profound brain damage” is misleading and unnecessarily frightening. There are medications that can cause confusion, delirium, sedation, or cognitive problems—particularly in older adults—but it is not accurate to say that seven commonly prescribed medicines simply “cause severe dementia and profound brain damage.”
Medicines that deserve particular attention
The strongest concern is with medications that have anticholinergic effects. Long-term exposure to a high overall anticholinergic burden has been associated with cognitive impairment and dementia risk, although observational associations do not prove that a particular drug directly causes dementia. The FDA has also noted concerns about cognitive effects with long-term use of some anticholinergic medicines.
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Examples include:
Oxybutynin — used for overactive bladder; it has significant anticholinergic effects.
Diphenhydramine — an antihistamine found in some sleep and allergy medicines.
Doxylamine — another sedating antihistamine used in some sleep products.
Certain tricyclic antidepressants — such as amitriptyline, which has substantial anticholinergic activity.
Certain bladder antimuscarinics — including tolterodine and solifenacin.
Benzodiazepines — such as diazepam and lorazepam; in older adults they can cause sedation, confusion, falls, and other harms and are generally approached cautiously.
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Some sedative-hypnotic medicines — certain sleep medicines can impair memory, alertness, and coordination, particularly in older people.
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But don’t stop these medicines suddenly
A medication appearing on a list of potentially problematic drugs doesn’t mean you should discontinue it. The American Geriatrics Society’s Beers Criteria identifies medications that may be inappropriate for older adults in particular circumstances; it is intended to support individualized clinical decisions, not to tell patients to abruptly stop treatment.
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If you’re 83 or older, medication review can be especially worthwhile because sensitivity to medicines and the effects of taking multiple medications can increase with age.
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If you give me the names of the medicines you currently take, I can go through them one by one and tell you which ones may affect memory, confusion, falls, or dementia risk, and which ones should never be stopped abruptly.
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