The People's Perspective on Medicine

Can You Reverse Memory Problems from Anticholinergic Drugs?

How would you know if your memory problems are related to the anticholinergic activity of medications you are taking? Find out which drugs are risky.

Many people, including a lot of health professionals, are unaware how many medications have anticholinergic activity. Perhaps even more alarming are the complications from a big anticholinergic “burden.” The more medicines a person takes that have anticholinergic activity the greater the risk of side effects such as memory problems, as this reader discovered:

Q. Are there antidotes to anticholinergic drugs? I have taken Benadryl (diphenhydramine), Paxil (paroxetine) and oxybutynin (Ditropan) for years.

I have read that such drugs can affect the brain. I feel as though my memory is half gone.

I am 83 and had a very good brain and a high IQ. I am worried and hope there are ways to reverse my mental decline.

A. There is growing recognition that drugs affecting the brain chemical acetylcholine can impair mental function, especially in older people (JAMA Neurology, June 1, 2016).  The medications you mention all have anticholinergic activity and could contribute to memory problems.

A Mediterranean Diet?

Your doctor may be able to reduce your exposure to this type of medication. Lowering the anticholinergic burden might possibly be helpful. Appropriate exercise and a Mediterranean diet may also benefit your brain. It may come as a surprise to learn that diet might be good for memory, but here is a review of the research: “Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence” (Advances in Nutrition, Sept. 15, 2016).

At age 83 we would not want you running or doing anything that might increase your risk for a fall. That said, many senior centers have safe exercise programs that can be done sitting down or in a swimming pool. Sometimes just using special exercise bands can improve muscle tone. And a daily walk can be beneficial.

The New Specialty of “Deprescribing”

Deprescribing:

The British Journal of Clinical Pharmacology (Nov. 4, 2015) proposed the following definition for deprescribing:

“Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes.”

Wikipedia defines deprescribing this way:

“Deprescribing is the process of intentionally stopping a medication or reducing its dose to improve the person’s health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient’s current situation.”

We think the Wiki definition hits the nail on the head. Medications that make us stupid or forgetful or increase our risk for dementia are likely to cause harm.

Identifying Potentially Harmful Drugs:

Geriatricians and those health experts who specialize in cognitive function have been advocating for medication audits to identify and deprescribe drugs with strong anticholinergic activity (Drug Safety, June, 2014). These authors note that 33 to 47% of older people who are admitted to hospitals are found to be taking such medicines. The researchers note that it is possible reduce anticholinergic drug exposure once such audits are undertaken.

Experts from Australia and New Zealand encourage deprescribing of anticholinergic drugs (Expert Opinion on Drug Safety, June, 2016). They state:

“…higher anticholinergic burden is a strong predictor of cognitive and physical impairments in older people. Anticholinergic burden is not only a concern related to long-term use of medicines with AA [anticholinergic activity] but short-term use as well. Anticholinergic exposure for as short as 2 weeks has shown to be associated with a decline in global cognitive function, visual memory, verbal fluency, and on activities of daily living.”

No one has done the research to determine if reducing the anticholinergic burden will reverse memory problems. These authors offer this expert opinion, however:

“It is postulated that minimizing anticholinergic burden in older people may result in improved short-term memory, confusion, behavior, and delirium together with an enhanced quality of life and daily functioning. Medicines with AA are to be best avoided in the geriatric population, unless considered clinically essential.”

A Collaborative Effort to Improve Memory Problems:

Here is a link to an expanded list of anticholinergic drugs. You may wish to bring it to your doctor’s attention.

Please let us know how you make out. You are not the only one to report that too many anticholinergic drugs can affect memory. Here are some comments from visitors to this website:

Donna in North Carolina shares a concern several others have also expressed:

“Atarax (hydroxyzine) and Benadryl (diphenhydramine) were routinely administered in the chemotherapy I received for breast cancer. After 5 months of chemo, I attributed my loss of mental function to a condition I read about called “chemo brain” — and chalked it up as another price paid in side affects for the benefit of staying alive.

“Because these two drugs were dispensed so often and so casually, I have taken them both since chemo, especially Benadryl, because I am allergic to certain insect bites, and because it can aid in sleep. The big-gun cancer drugs have caused organ damage, aging organs 20-25 yrs, I’d say. It may be that the anticholinergics are responsible for the most frustrating loss I have experienced! I remember reading about taking choline back in the 1970’s and wonder if that would be helpful for my memory.”

Aurie in Michigan offers an interesting observation:

“I have been taking allergy meds since I was just a child. I am now 78 years old. On top of that, I have been on many other anticholinergics over the years as well. Now I know why my memory problems are increasing! I truly believe the less drugs the better!

“Outside of Vitamin B-12 shots once every few months, my grandma did not take any prescription drugs and she lived to be 97. She also ate plenty of butter, cooked with lard and bacon grease. So there!”

Derborah in Brooklyn, MD:

“Wow. I have been thinking that I’ve lost my mind. Can’t remember stuff I did 5 minutes ago. My long term memory is so much better than the short term memory. No wonder. I take 5 of the medications on this list. I have got to get off of these meds. I just turned 57 and was thinking that I have early onset oldtimers!

To see a list of drugs that are potentially problematic for senior citizens, check out our Guide to Drugs and Older People in our Health Guides.

To learn more about how to avoid medication misadventures in general you may find our book helpful: Top Screwups Doctors Make and How to Avoid Them.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I have been on lamotrogine and celexa for over 20 years. I understand that lamotrogine causes memory loss.

What would be a good substitute? Is there any bi-polar natural or pharmaceutical drug that does not cause memory loss? I am 65.

When I found out the information regarding Paxil being a possible cause of dementia, I feel that doctors, mine and every MD, have been irresponsible. I’ve been on Paxil for years and have a strong family history of dementia. Right now I feel betrayed by my doctor by not discussing this issue with me. She certainly must be taking or reading JAMA and hopefully other related journals that published this information. It’s my life, my choice, and my possible dementia. Luckily, I am a healthy eater and active. Yet, I want to have a deep discussion with my doctor. I only wish she had brought up the subject, not me the patient.

i am a diabetic for the last twenty years. take glipiride and metaform and zoloft daily. i have severe dry mouth. i chew gum daily for saliva as drinking lots of water does not help, or,some times suck on a no sugar cough drop. is zoloft responsible for the dry mouth. thanks

When discussing medications my doctors, they rarely disagree with what they have prescribed. They poo-poo any supplements I ask about and make me feel like nothing on the internet can be factual. Very scary. People are aware of their bodies and know when something isn’t right. Just try to get it through to your doctor.

THANK YOU FOR THE INFO ON THIS VERY IMPORTANT SUBJECT. JERRY

My wife of 39 years has been on Tramadol for several years for pain relief of deteriorating
and bulging discs. She also has Parkinson’s disease. The Parkinson’s disease is being treated with Levadopa/Carbadopa. Since early March 2018 she has had symptoms of confusion, difficulty paying attention, cognitive decline, dry skin, unsteady gait, confusion, disorientation, fatigue, muscle weakness, clumsiness, unsteadiness, visual difficulties, constipation, difficult urination (at times), difficulty swallowing, along with dry mouth and nose. Quetiapine was recently prescribed for confusion.

Thiamine deficiency!

I take Spiriva which is anticholinergic but makes my copd much easier to live with. This article seems helpful http://www.drdalepeterson.com/Anticholinergics_996.html

And thanks for this article and the comments.

Please research new studies on supplemental magnesium L-threonate. This form passes the blood brain barrier and studies show it improves memory.

Suppression of this information is criminal. I finally find out now, 2017?

What about supplementing with Bacopa Monierri Extract and Citicoline to help reverse the negative effects of years or taking anticholinergic drugs?

I have been on the medication Xifaxan and have found that I am having problems focusing and concentrating on work. In addition, I am exhausted all the time and even a little short tempered. I will be trying less of the product and see if I can reverse this feeling which is making me feel like I am losing my mind.

Wow. I have been thinking that I’ve lost my mind. Can’t remember stuff i did 5 minutes ago. My long term memory is so much better than the short term memory. No wonder. I take 5 of the medications on this list. I have got to get off of these meds., I just turned 57 and was thinking that i have early onset oldtimers!!

Really benficial discoures! Some summarizing, integrating ways. Must…among age, organ, physiological process, lifestyle, psychology…another burning issue is drug interactions, that must desconinate dyanamically…thanks a lot..

I started Doxepin 50mg 13 years ago. After some sleepless nights, last month my doctor raised me to 100mg. Yes, sleep is great now. Yes, I am experiencing some memory loss. What was once a good recall memory, I now have trouble finding the proper words. I remember trying to stop Doxepin a couple of years ago. Cold turkey is not the way to go. This time I will use the stair-step method. Hope to send Doxepin out with Mr. Obama.
Thanks for your article.

I live in a community with many brain-injured people, many mentally-challenged people, and many elderly. It’s often impossible to tell which is which when attempting to converse, because so many of the elderly are on so many drugs that their memories and mental skills are not perceptibly above those in the other groups. What is being done to the elderly medically and pharmaceutically in this country is criminal.

I’m very pro active now with my health. This site is so informative!
However, I did not come here for the political statements.

I took Benadryl for my sleep problems almost every night for a few years. During that time my brain got very foggy and I had increasing trouble doing my work as a writer. As soon as a friend told me about the bad effects of Benadryl I stopped taking it — about three years ago. The brain fog has greatly lessened and I think my memory improved a bit, but there are some lingering effects in having trouble concentrating. I’m 73, I eat well, take many supplements but no pharmaceutical drugs, and get a decent amount of exercise. I’m hoping I continue to improve. It was a bitter blow to have to stop taking Benadryl as it was the most effective sleep aid I’ve ever found.

My husband’s grandmother, who raised him, lived to the age of 99 and had a perfect mind all her life right to the end. She took no medications from her late 20’s on but relied all those years on Christian Science. She was a very kind and loving person and believed that thoughts affect health.
It was a joy to know her and discuss ideas with her right until she passed on at nearly 100. Drugs do have side effects and our thoughts and attitudes do make a difference in our total well being.

I was hoping to come here to find something that would save me from losing my memory after years of taking anticolinergic drugs to sleep. Ambien, Benadryl. Etc. but I am only seeing other peoples experience with this and would like to know if there are any studies that show that stopping these drugs, or anything that will remove whatever it is doing to the brain? I recently read that taking 3 teaspoons of organic coconut oil per day will help counteract what colinergic drugs have done to the brain. I have been doing that for the last week and I swear, that I believe I can remember numbers a little better. However that stuff gives me severe diarrhea. I am trying to figure out how I can still take it and not have diarrhea. Because I think it might be working. Any thoughts? I came looking for a real answers and not just everyone’s experience, although that is interesting to read.

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