Dementia is as feared as cancer. The general consensus is that dementia is an old-age process and it terrifies people. However, working in the mental heath outpatient department at the Fayetteville, Arkansas VA, we were seeing early onset dementia. Most of this early onset dementia was seen in veterans who used marijuana on a regular bases.

What are other causes of dementia?

Many commonly prescribed medications can cause dementia. The commonly known memory interfering and dangerous medications are those with anticholinergic properties. Medications that block the effect of acetylcholine. Acetyclcholine is an important brain chemical and neurotransmitter that becomes less plentiful in the aging brain. Acetylcholine is essential for brain health and function.

These medications have an impact on brain cells. By blocking the receptor molecules in the brain these medications can help people experience relief from symptoms such as insomnia, irritable bowel syndrome, and many other medical conditions. Among the clinically significant anticholinergic medications are medications such as tolterodine, which is often used to treat urinary incontinence. In addition, some antidepressants like the tricyclics such as amitriptyline, antipsychotics, cardiac medications, antispasmodics, antivertigo medications, and antiparkinsonian medications have anticholinergic effects.

Anxiety and Insomnia Medications

Benzodiazepines are a class of medications that are used to treat anxiety or insomnia. These medications are another group that has been linked with cognitive difficulties. While these medications can give significant relief to individuals suffering from debilitating anxiety, their use has a sedation and mental slowing side-effect are concerning. A recent study has suggested that prolonged use of benzodiazepines might be a risk factor for dementia. Primary care doctors continue to prescribe anti-anxiety medications such as lorazepam (Ativan) and alprazolam (Xanax) or sleeping pills such as temazepam (Restoril) and consider them very beneficial when used properly. The psychiatrist I have worked with do not prescribe benzodiazepines because of the serious side-effects.

Corticosteroids

Corticosteroids can be life-saving for people having sever allergic reactions when prescribed accordingly. However, they have the capacity to induce delirium, mood changes, or even psychotic symptoms. Prednisone has been identified in cases of clinical symptoms that mimic different mental disorders including cognitive changes. I was given Prednisone once and I literally felt homicidal. I had only taken three of the pills when this symptom onset. I warned my teenagers to stay away from me until the pills wore off. Teenagers tend to push a parents buttons on a good day.

Pain Medications

Pain medications, especially opioids, can be life changing when used properly. Their disastrous effects on short-term memory have been studied and recognized. Pain relief is necessary for an individual to be able to function. The proper use of pain relievers is important so people can function. However, negative cognitive effects are reversible after the medications are stopped. Opioids were never intended for long-term use. Doctors started using them in this off-label prescribed treatment which has caused the devastating problem we now see. Opioids were one of the biggest problems I had to deal with as a nurse trying to educate my patients. It’s the most abused category of drugs.

Chemotherapy Drugs

Cognitive changes associated with anticancer chemotherapeutic agents is well-documented. “Chemo brain” is now a commonly known term that describes the affects chemotherapy has on patients. The side-effects include being unable to focus or lack of attention, working memory, and executive function. Unfortunately these side-effects sometimes leaves lasting changes.

Statins

The cholesterol-lowering statins have been suspected of creating mental slowing and memory problems in some people for a while now. The research in this area is divided in opinion. Smaller case studies have reported people are experiencing the medications interfering with cognition. Other larger and well-designed studies have not confirmed this effect. So, the jury is still out on whether this is a side-effect or not.

Recently, more doctors are acknowledging that the true benefits of this classification of drugs is in question. Newer studies are showing that the Statins are not very effective, especially considering the severity of the side-effects.

The Impact of Aging

We need to be aware that the effects of aging with drug action and metabolism are of the upmost importance. The liver and kidneys are less efficient in detoxing drug effects as we age. The aging brain has less protective cognitive resources. More importantly, the practice of multiple prescribed medications for older adults offer many opportunities for drug interactions. All medications have adverse reactions. The harmful effects of medications are exacerbated when the medications are not taken as prescribed. Then when alcohol is thrown into the mix it’s a disaster happening. Even a small amount of alcohol use can add serious adverse side-effects of medications.

So, the fact that your can’t remember, might not be dementia. There are safer drugs and alternative therapies that are effective.

Don’t forget about over the counter drugs!

Common medications such as Benadryl which is commonly used not only for allergies, but as a sleep aid can affect your memory.

Never stop or change any medication regimen without talking with your doctor first. Never add over the counter drugs without talking with your pharmacist first.