The People's Perspective on Medicine

Protecting Brain Power as We Age

Senior moments don’t just happen to octogenarians. Almost everyone has had a disconcerting momentary lapse in memory.
For some it’s the inability to recall the name of the famous actor who starred in a popular movie last year. Others may forget a well-known phone number. Then there’s the embarrassing encounter with a person whose face is familiar but whose name you cannot recall.
Most of these slips are not early warning signs of Alzheimer’s disease. But as baby boomers age, they worry about losing their cognitive edge.
Many people would like a strategy to boost their brain power or at least prevent mental decline. No pills have yet been proven to make people smarter or protect them from dementia. There are, however, an astounding number of drugs that can interfere with cognitive function.
Acetylcholine is a crucial chemical that is essential for communication between brain cells. Many medications can impair the activity of this neurotransmitter. Such medicines are said to have “anticholinergic” activity.
Some of the most well known are available over the counter. Diphenhydramine (DPH) is an antihistamine found in allergy medicines like Benadryl. It is also a common ingredient in sleeping pills (Nytol, Simply Sleep, Sominex, etc) and nighttime pain relievers (Advil PM, Excedrin PM, Tylenol PM, etc).
Other commonly used medications with anticholinergic activity include those prescribed for overactive bladder, such as fesoterodine (Toviaz), oxybutynin (Ditropan) and tolterodine (Detrol). Physicians and family members may not realize that an older person’s increasing confusion and disorientation could be exacerbated by one of these drugs (Journal of the American Geriatrics Society, Dec. 2005).
Other medicines that could have a negative effect on cognitive function because of their anticholinergic action include the anti-anxiety agent alprazolam, the antidepressant amitriptyline, the ulcer drug cimetidine, the heart drug digoxin and the diuretic furosemide.
No one should ever stop such medications without medical consultation. Some of these drugs may be absolutely essential. People who would like a more detailed list and discussion of anticholinergic drugs may find our Guide to Drugs and Older People useful (www.peoplespharmacy.com).
Avoiding troublesome medications is only the first step in staying sharp. Investigators find that aerobic exercise helps promote cognitive function (Frontiers in Aging Neuroscience, online, Nov. 29, 2010). Not only does regular vigorous physical activity increase neuron formation and connections, it also facilitates mental flexibility.
Diet may also play a role in maintaining healthy brain function. A recent study of older residents on the South side of Chicago found that those who followed a Mediterranean-style diet rich in vegetables, olive oil, fish and whole grains were less likely to experience significant cognitive decline during the seven-year follow-up period (American Journal of Clinical Nutrition, online, Dec. 22. 2010).
Once again the time-honored advice to eat right and exercise regularly may be beneficial for both the body and the brain. Avoiding drugs that contribute to brain fog can also be a crucial step towards staying sharp.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Where is the list?

I just returned from visiting my sister, Anna, in Washington State. She has liver disease, thyroid disease, frontal temporal disorder. She has recently had dementia and hallucinations. After much research online I saw that parkinson medicine that she was on for hand shaking, and the anti-psychotic medicine she was on for hallucinations could cause dementia to get worse.

We took her off this medicine and she improved drastically. I have become very interested in what our Meds are doing to us since. I thank you very much for this site. It has helped me imensely for myself and another sister which is showing sign of dementia also.

Is meloxicam an anticholinergic drug?

Thanks for the help!! I am very thankful at this point that I cannot take these things. I am allergic to nearly all prescription or over the counter drugs so doctors don’t like to see me come in… especially when herbal treatments are mentioned.
This is critical info to pass along to friends and family. Thanks so much for your efforts, they are greatly appreciated.
Sincerely,
W.W. New Mexico

I have been taking a generic sleeping tablet from wal-mart that is Diphenhydramine. I plan to stop it immediately even though it works well because I have always had a bad memory and I cannot afford any mental decline.

Hi,
My husband is on Avodart for prostate and bladder problems. Is that an
anticholinegric? He has been diagnosed with dementia but they don’t know if it’s FTD or the lead up to Alzheimers. Could Avodart be adding to his confusion?

This article is very interesting but understand that for some people one or more of these drugs is absolutely necessary for health. It would be good to know which are the most damaging.

Informative article. I take DMAE/H3 drops (a form of acetylcholine) and it helps me think better and gives me energy. I read DMAE is used for ADD in Europe.
KJ -I agree. Doctors are too ready to hand out prescriptions. We all need to read the medical lit. Prescriptions made me very sick. I researched (horrible side effects!); my pharmacist was great, printing out extensive information for me. (The info sheets that come with prescriptions are a page or two – my pharmacist printed out 30-page summaries for me from his professional database, bless his heart. I don’t think the prescribing doctors knew any of that information and it was scary.)
A Harvard/Yale-educated doctor wanted to put me on lipitor. My cholesterol’s high, but the ratios are fine. I refused. She got mad! I lowered my cholesterol some with diet. My grandparents had high cholesterol and lived into their 90s. I have friends that had terrible side effects on cholesterol drugs; they weren’t sick before, but now they are. The ads are worded so carefully: “MAY cause heart disease…” That’s not saying it WILL.
Too bad, you can’t trust them any more. Drug reps just want to sell more; I know some – they have contests, just like who can sell more merchandise in those home party schemes! Winners get a cruise! Patients get… you know.

Several years ago I was given a combination of Inderal and Elavil for migraine headaches – which I did not have. I had frustration, anger, and job burnout. But I allowed the doctor to convince me to try it. In six months I had gained 40# and lost 60% of my hair. I told him I stopped the stuff. He wanted me to continue “it makes you feel better.” “It made me fat, bald, and ugly. That does not feel better.” Now I take almost no prescription drugs and those few very carefully.

I enjoyed the article to a point. Not knowing the actual names of the various drugs I would have liked it better if you had listed the names under which the drugs are sold, e.g. Tylenol or whatever. I take Imodium for a problem. Does it impact on memory or have any other side effect?
If at all possible I would like an answer. Thank you.
PEOPLE’S PHARMACY RESPONSE: HERE ARE THE NAMES: ALPRAZOLAM IS XANAX; AMITRIPTYLINE IS ELAVIL; CIMETIDINE IS TAGAMET; DIGOXIN IS LANOXIN AND FUROSEMIDE IS LASIX.

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