Americans are justifiably concerned about Alzheimer’s disease and other forms of dementia. Aging baby boomers are hitting the age where they could be vulnerable to cognitive decline. Anticholinergic drugs like amitriptyline have been especially problematic. A German study published in PLOS One (online, Feb. 10, 2017) reported that drugs with the most anticholinergic activity like amitriptyline (Elavil) and quetiapine (Seroquel) were linked to greater mental decline. That is why this question from a reader is so relevant.
Is Amitriptyline Contributing to Dementia?
Q. My wife, 76, has been taking amitriptyline since 2013. Just last week, the results of a PET scan confirmed she has dementia. Her neurologist said the amitriptyline should not have been much of a factor, but I wonder.
A. Amitriptyline is an old-fashioned antidepressant. It is included on the Beers List of drugs that should be avoided or used with extra caution for people over 65 (Pharmacist’s Letter, Nov. 2015).
Anticholinergic drugs like amitriptyline can contribute to confusion, memory problems and cognitive impairment. There are literally dozens of drugs that have anticholinergic activity. Many people do not realize that several of the drugs they may be taking could have an impact on brain function. Side effects of such medicines can include:
- Dry mouth and nose
- Confusion, memory problems
- Blurred vision and other visual difficulties
- Difficulty urinating
- Dizziness, unsteadiness
We have compiled a list of anticholinergic drugs so people can discuss this issue with their physicians. No one should ever stop taking a medication without a conversation with the health professional who prescribe it.
Stories from Readers:
One of the strongest anticholinergic drugs is scopolamine. This reader shared a sad scopolamine story:
“My wife used a scopolamine patch for three weeks on a vacation to prevent motion sickness which it did. Unfortunately it also caused memory loss.
“That was over four years ago and memory loss continues to this day. We have met with three neurologists and they have done brain scans but offered no remedies.
“Prior to the day the scopolamine patch was attached my wife had absolutely no memory problems or symptoms of dementia or Alzheimer’s and her life style and family history indicated no danger signs.”
Eileen in Alberta is caught between the proverbial rock and a hard place:
“I have been on amitriptyline for my fibromyalgia. Although I have tried other meds, Elavil is the only one that works.
“Once I had a photographic memory, but now I am suffering memory loss and I can’t remember from second to second. I have also been having dizziness.
“I have been on this medication for twenty years. When I tried getting off the med, after two weeks I could hardly move and had severe pain every where. I don’t know what to do.”
Abigail in NV says:
“Please add loperamide (Imodium) and Lomotil (diphenoxylate plus atropine ) to your list of anticholinergic drugs. And add to the symptoms poor balance (risk of falling).
“I have experienced cognitive difficulties from these drugs and, when I take them, I have difficulty walking a straight line and balancing while going up and down steps. The cognitive problems mimic dementia. The balance problems can be dangerous.”
Thanks for the tip, Abigail. Those drugs are indeed anticholinergic and we have added them to the list.
So you and others can learn more about this problem and other drugs that may be inappropriate for senior citizens, we are sending you our Guide to Drugs and Older People.
Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped (70 cents), self-addressed envelope:
- Graedons’ People’s Pharmacy, No. O-85
- P. O. Box 52027
- Durham, NC 27717-2027
It can also be downloaded for $2 from the website: www.peoplespharmacy.com.