Aging Brains Experience Long Term Cognitive
Impairment from Common Drugs in Study
Taking one anticholinergic (Tylenol PM, Benadryl,
etc.) significantly increases
risk of developing mild cognitive impairment and taking two doubles this
risk
|
 Anticholinergics are sold over the counter under various brand
names such as -
● Benadryl,
● Dramamine,
● Excedrin PM,
● Nytol,
● Sominex,
● Tylenol PM, and
● Unisom.
Other anticholinergic drugs are available only by
prescription, such as -
● Paxil,
● Detrol,
● Demerol and
● Elavil.
|
July
14, 2010 – In a study of elderly African-Americans it was found that
drugs consumed often for a variety of common medical conditions
including insomnia, allergies, or incontinence negatively affect the
brain causing long term cognitive impairment. The researchers are
confident future studies will find that the results will also apply to
senior citizens of other races.
These drugs, called anticholinergics, block
acetylcholine, a nervous system neurotransmitter, and are widely-used
medical therapies. Older adults most commonly use drugs with
anticholinergic effects as sleep aids and to relieve bladder leakage
problems.
They are sold over the counter under various brand
names such as Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol
PM, and Unisom.
Other anticholinergic drugs, such as Paxil, Detrol,
Demerol and Elavil are available only by prescription.
The study appeared in the July 13, 2010 print issue
of Neurology, the medical journal of the American Academy of
Neurology.
Researchers from Indiana University School of
Medicine, the Regenstrief Institute and Wishard Health Services
conducted a six-year observational study, evaluating 1,652 Indianapolis
area African-Americans over the age of 70 who had normal cognitive
function when the study began.
In addition to monitoring cognition, the
investigators tracked all over-the-counter and prescription medications
taken by study participants.
"We found that taking one anticholinergic
significantly increased an individual's risk of developing mild
cognitive impairment and taking two of these drugs doubled this risk.
This is very significant in a population – African-Americans – already
known to be at high risk for developing cognitive impairment," said Noll
Campbell, PharmD, first author of the study. Dr. Campbell is a clinical
pharmacist with Wishard Health Services.
|
Tylenol PM, Benadryl in Recall
Tylenol
PM and Benadryl are among products currently being recalled by
McNeil Consumer Healthcare. The company has recalled 21 lots of
over-the-counter medicines, as a follow-up to a product recall
originally announced on January 15, 2010. It was initiated
following consumer complaints of a musty or moldy odor, which
has been linked to the presence of trace amounts of a chemical
called 2,4,6-tribromoanisole (TBA). The risk of serious adverse
medical events is remote, the company says.
Click here to the news release and complete recall list. |
"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.
“As a geriatrician I tell my Wishard Healthy Aging
Brain Center patients not to take these drugs and I encourage all older
adults to talk with their physicians about each and every one of the
medications they take," said Malaz Boustani, M.D., IU School of Medicine
associate professor of medicine, Regenstrief Institute investigator and
IU Center for Aging Research center scientist.
"The fact that we found that taking
anticholinergics is linked with mild cognitive impairment, involving
memory loss without functional disability, but not with Alzheimer
Disease, gives me hope. Our research efforts will now focus on whether
anticholinergic-induced cognitive impairment may be reversible," said
Dr. Boustani, who added that "this study offers a new window to change
the burden of dementia" for the individual, the caregiver and the
healthcare system."
"This finding of a link between anticholinergics
and long term mild cognitive impairment complements our previous work
which confirmed a link between anticholinergics and delirium, which is a
sudden onset cognitive impairment," said Dr. Campbell.
Although this study, which was funded by the
National Institute on Aging, looked at only African-Americans, both Dr.
Campbell and Dr. Boustani believe future studies will find that the
results are generalizable to other races.
In addition to Campbell and Boustani, co-authors of
"Use of Anticholinergics and the Risk of Cognitive Impairment in an
African-American Population" are Hugh Hendrie, MB, ChB, DSc, of the IU
School of Medicine and the Regenstrief Institute; Valerie Smith-Gamble,
M.D. of the IU School of Medicine and the Roudebush VA Medical Center;
and Kathleen A. Lane, M.S., Sujuan Gao, Ph.D., Babar A. Khan, M.D., Jill
R. Murrell, Ph.D., Frederick W. Unverzagt, Ph.D., Ann Hake, M.D., and
Kathleen Hall, PhD. of the IU School of Medicine. Dr. Hall is also a
Regenstrief Institute affiliated scientist.
A downloadable list of medications with
anticholinergic effects can be found on the website of the
Indianapolis Discovery Network for Dementia, of which Dr. Boustani
is the founder and scientific director. For a direct link to the drug
list and other information in pdf format –
click here.
The IU School of Medicine and the Regenstrief
Institute are located on the campus of Indiana University-Purdue
University Indianapolis.
