7 medications that cause severe dementia and profound brain damage

Seven medication groups worth reviewing

1. Diphenhydramine — a first-generation antihistamine found in some allergy and sleep products. It has strong anticholinergic effects and can cause confusion and delirium, particularly in older adults.

2. Oxybutynin — used for overactive bladder. It has significant anticholinergic activity, and among bladder antimuscarinics, the evidence for adverse cognitive effects is particularly concerning. PPubMed Central (PMC)

3. Amitriptyline — a tricyclic antidepressant with strong anticholinergic and sedating effects. The AGS recommends avoiding it in older adults when possible. PPubMed Central (PMC)

4. Paroxetine — an SSRI with relatively strong anticholinergic activity compared with other SSRIs. PPubMed Central (PMC)

5. Hydroxyzine — an antihistamine with strong anticholinergic properties that can contribute to confusion and other CNS effects, particularly in older people. PPubMed Central (PMC)

6. Benzodiazepines such as diazepam, lorazepam, and alprazolam — these can cause sedation, impaired memory, confusion and falls. The 2023 AGS Beers Criteria recommends avoiding benzodiazepines in older adults except in appropriate circumstances. PPubMed Central (PMC)

7. Z-drugs such as zolpidem — these sleep medicines can cause adverse CNS effects and are also listed by the AGS as medications to avoid in older adults with dementia or cognitive impairment