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Anticholinergics
Feb 29th, 2012 Headlines

Taking medicine can help what ails you, but using certain drugs in the wrong combination can cloud your brain. The elderly are especially vulnerable to this.

Anticholinergics are medications that block a chemical or neurotransmitter in the brain, called acetylcholine. There is mounting evidence that chronic use of these medications can impair memory, especially in the elderly.

An example of an anticholinergic is diphenhydramine. It is an antihistamine found in Benadryl and a host of over-the-counter cold and allergy remedies (Tylenol PM and Theraflu), over-the-counter sleep aids (Unisom and Sominex), and motion sickness medications (Dramamine).  Other drugs with anticholinergic properties include antidepressants, like Paxil and Elavil, and the popular bladder incontinence drug, Oxybutynin or Ditropan.

We have known that anticholinergics can have a whole host of side effects like dry mouth, blurred vision, and increased heart rate. In addition to this, there is even more evidence that they can cause memory loss and confusion, especially in the elderly.  There was a study published last year that looked at more than 13,000 British men and women at age 65 or older. Those who took more than one anticholinergic drug scored lower on memory tests than those who didn’t. Heavy users of these medications had a 68 percent higher death rate, and it’s unclear why.

In general, elderly patients are often more prone to side effects from medications.  Anticholinergics are no exception.  As our bodies age, we have less skeletal muscle and our kidneys do not work as efficiently. Therefore, the same dose of a drug in a younger patient may have a greater effect on an older patient.  Plus, older patients are more likely to be on more medications, which can interact with each other and raise the risk of unpleasant side effects. It’s estimated that about 20% of older Americans take at least one of these medications.

Fortunately, experts who have studied this believe the effects are reversible.

Patients should be sure to keep their doctors informed about all of the prescription medications they are taking, as well as any non-prescription or alternative medicines they are using. Doctors can sometimes prescribe substitute medications without anticholinergic effects.  Remember, just because a medication is sold without a prescription, it’s not without side effects.  Be careful before you overmedicate on your own!



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