Paxil, Tylenol PM, Other Drugs May Impair Thinking in Elderly

Drugs in the class called anticholinergics, which include over-the-counter (OTC) products such as Benadryl, Dramamine, Excedrin PM, Sominex and Tylenol PM and prescription drugs such as Paxil, Detrol, Demerol, and Elavilhave been found to create a two-fold risk of impaired thinking in some elderly, said the LA Times. Specifically, the effects were seen in older African Americans, and are believed to also affect Caucasians, said the LA Times, citing researchers.

Anticholinergics block the activity of a specific neurotransmitter and are administered to the elderly to help with sleep and bladder leakage issues, explained the LA Times. The drugs have also been linked to an increased risk of delirium, described as a type of “sudden-onset cognitive impairment,” reported the LA Times. A list of medications with anticholinergic effects can be accessed here.

Because African Americans are known to be at higher risks for cognitive impairment, the study focused on this demographic in a team led by Dr. Malaz Boustani of the Regenstrief Institute at the Indiana University School of Medicine, said the LA Times. The team also used the work of an ongoing study—The Indianapolis Ibadan Dementia Project—that is looking at a comparison of risk factors for dementia in this group in both Indianapolis and Yoruba in Ibadan, Nigeria.

The newer study involved 1,652 participants from Indianapolis, who are black, and who did not suffer cognitive impairment at the start of the study, said the LA Times. After collecting information and medications from the participants’ homes, the team determined that 11 percent of the participants took anticholinergics, wrote the LA Times.

The team, which just reported in the journal Neurology, and after six years of follow up, determined that patients taking just one anticholinergic were 46 percent likelier to suffer from cognitive impairment; those taking two experienced a two-fold increase. A surprising outcome was that the risk was also increased in those participants who did not carry the E4 variant of the gene APOE, which is involved in triglyceride metabolism (triglycerides are a cholesterol). The surprise is that APOE E4 is known to increase the likelihood of an increased risk of developing Alzheimer’s disease.

“Simply put, we have confirmed that anticholinergics, something as seemingly benign as a medication for inability to get a good night’s sleep or for motion sickness, can cause or worsen cognitive impairment, specifically long-term mild cognitive impairment which involves gradual memory loss,” Boustani said, quoted the LA Times. “I tell all my [elderly] patients not to take these drugs…. Our research efforts will now focus on whether anticholinergic-induced cognitive impairment may be reversible,” he added.

We recently wrote that two separate reports written by researchers at Wake Forest University School of Medicine supported findings concerning anticholinergic medications and that these drugs might adversely affect the thinking skills of older patients, a phenomenon not observed in those patients studied who do not take these medications. The studies also indicated that anticholinergics may cause older patients to experience a decrease in their daily physical activities.

We also wrote that another study linked some commonly used incontinence drugs to memory problems in some older patients.

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