In a report published in “Journal of the American Medical Association (JAMA) Internal Medicine,” researchers offers compelling evidence of a link between long-term use of anticholinergic medications like diphenhydramine (Benadryl) and chlorpheniramine maleate (Chlor-Trimeton) and dementia in older individuals. The report is important because of an increased risk in older individuals of developing dementia and Alzheimer’s disease.
It well known that anticholinergic drugs block and prevent the action of acetylcholine in the nervous system. In the brain, acetylcholine facilitates learning and memory — both short and long term memory. In addition acetylcholine increases muscle contractions, enhancing movement throughout our body, throughout our lives. It is a long term effect.
Some of the anticholinergic medications in the report include antihistamines previously identified and some antidepressant medications. Some anticholinergic medications are used to control overactive bladder such as oxybutinin (Ditropan), and some anticholinergic drugs are used to relieve the symptoms of Parkinson’s disease like benztropine (Cogentin) and trihexyphenadryl (Artane). These medications described are not known to directly cause dementia but for some individuals 60 years or older that may have beginnings of dementia, the drug will likely worsen the symptoms to become more obvious.
Thanks to scientific discoveries, we now have newer antihistamines such as loratadine (Claritin) which can replace diphenhydramine or chlorpheniramine (Chlor-Trimeton). Loratidine is an effective drug with less side effects.
Anticholinergic drugs are often used for control of an overactive bladder and urge incontinence. Another option is cognitive behavioral training which has been shown to likewise be effective.
One of the best ways to make sure you’re taking the most effective drugs is to place all your medications — prescription and nonprescription — into a bag. Bring them to your next appointment and review each one with your primary care doctor.
Always be a wise consumer, read the label carefully before you make your choice. Consult your physician or pharmacist and be sure to ask questions. Be a wise consumer and choose the best and leave the rest. Choose wisely and save money.
Keith Miller, Pharm.D.