Bladder Drug Triggered Dementia Symptoms

Q. I want to sound an alarm about Gelnique in elderly patients. My 86-year-old father applied this gel for bladder control.
After three weeks of daily use, he started acting odd. A month in, he had symptoms of dementia. The insert that came with the drug never mentioned this as a side effect.
I made him quit taking it because he developed a rash. Not only did the rash go away, but so did most of the cognitive symptoms. Hopefully he will get back to where he was once the drug is out of his system.
I don’t want others to lose their minds needlessly. Thank goodness I did not chalk this reaction up to his age as his physician did.
A. Your father was fortunate that you were so vigilant. Drugs for overactive bladder such as oxybutynin (Ditropan, Gelnique, Oxytrol) can affect memory and cognition, especially in older people (Current Urology Reports, Oct. 2011). Whether the drug is taken orally or as a patch or gel, it gets into the circulation and can affect the brain.
Many other medications may also interfere with optimal brain function in the elderly (Der Internist, Oct. 2012). They include anti-anxiety drugs such as alprazolam (Xanax) or lorazepam (Ativan), certain antibiotics (e.g., ciprofloxacin), some antidepressants (amitriptyline, doxepin) and narcotic pain relievers (oxycodone).
We are sending you our Guide to Drugs & Older People for more detailed information about many other medications that should not be taken by seniors. We hope that will help you as you monitor your father’s health in the future.