Sleeping Pills Increases The Risk of Alzheimer's and Dementia in Older People
A new study has found a significant link between high use of
Anticholinergic drugs - including popular non-prescription sleep aids and the
antihistamine Benadryl (diphenhydramine) - and increased risk of developing
Dementia and Alzheimer's disease in older people.
Many medications - including some popular over the counter drugs - have strong anticholinergic effects. |
Anticholinergics are a class of
drug that blocks the action of the neurotransmitter acetylcholine in the brain
and body.
Prof. Gray says:
Prof. Gray urges people not to
stop their therapy based on the findings of this study - they should talk to
their health care provider, and also tell them about all their over-the-counter
drug use.
Taking anticholinergics for more
than 3 years linked to higher Dementia risk
For their study, Prof. Gray and
colleagues tracked nearly 3,500 men and women aged 65 and over with no Dementia
symptoms at the start of the study. The participants were part of the Adult
Changes in Thought (ACT) study in Group Health, an integrated health care
delivery system in Seattle.
From the pharmacy data they added
up all the standard daily doses and worked out the cumulative anticholinergic
exposure for each participant over the past 10 years. This was updated as
participants were followed up for an average of 7 years.
Over the period of the study,
nearly 800 participants developed Dementia.
The results showed that the most
commonly used medications were tricyclic antidepressants (for example, Doxepin or Sinequan), first-generation antihistamines (chlorpheniramine,
Chlor-Trimeton), and antimuscarinics for bladder control (Oxybutynin, Ditropan).
The researchers estimated that
people taking at least 10 mg per day of doxepin, 4 mg per day of
chlorpheniramine, or 5 mg per day of oxybutynin for more than 3 years would be
at greater risk for developing dementia.
Prof. Gray also told Medical News
Today the dose risks associated with Benadryl: "The dose of
diphenhydramine that would correspond to the highest risk group is taking the
equivalent of 50 mg each day for longer than 3 years - or 25 mg per day for
longer than 6 years in duration."
Prof. Gray says there are
alternative non-anticholinergic drugs for doxepin and chlorpheniramine. For
example, to treat depressions there are the selective serotonin re-uptake
inhibitor (SSRI) like citalopram (Celexa) or fluoxetine (Prozac). And there are
second generation antihistamines like loratadine (Claritin) for allergies.
However, while there are not many
alternatives to oxybutynin for increasing bladder control, she suggests
behavioral changes may be an option.
Some of the ACT participants have
agreed to have their brains autopsied after they die. This might reveal if
taking anticholinergic medications is more likely to result in brain changes
that are characteristic of people who develop Alzheimer's disease.
Funds for the study came from the
NIH's National Institute on Aging and the Branta Foundation.
Meanwhile, Medical News Today
recently learned how a team of scientists and engineers are developing an MRI
method for non-invasive, early detection of Alzheimer's disease. They have so
far shown that it works in animals. The new brain imaging method detects the
toxin that leads to Alzheimer's disease before typical symptoms appear.
Over-the-counter sleeping aids
and hayfever treatments can increase the risk of Alzheimer’s disease, a study
has found. The sleeping medication Nytol and anti-allergy pills Benadryl and
Piriton all belong to a class of drug highlighted in a warning from
researchers.
Each of these drugs has “anticholinergic”
blocking effects on the nervous system that are said – at higher doses – to
raise the likelihood of developing Alzheimer’s and other forms of Dementia
significantly over several years.
Anticholinergic drugs block a
nervous system chemical transmitter called acetylcholine, which can lead to
side-effects including drowsiness, blurred vision and poor memory. People with
Alzheimer’s disease are known to lack acetylcholine.
The leader of the US study, Professor
Shelly Gray, director of the geriatric pharmacy programme at the University of
Washington School of Pharmacy, said: “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. And they
should tell their healthcare providers.
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