Have you ever discovered that a jacket you once loved no longer delights you? Perhaps the style has changed, or maybe you have changed and it is now too large or too small. Giving up a jacket that has gone out of fashion may be easier than recognizing that a medication that was once appropriate could have become harmful. This reader asks, could memory worsen as a result of taking a migraine medicine first prescribed many years ago?
Would Amitriptyline Make Memory Worsen?
Q. I noted with interest your column on amitriptyline and its side effects of memory loss and cognitive decline. I have taken this drug to prevent migraines for more than 20 years.
At 74, I have short-term memory loss and cognitive concerns. Would stopping this drug now repair any damage it might have done?
Amitriptyline and Anticholinergic Activity:
A. Amitriptyline is an old-fashioned antidepressant with substantial anticholinergic activity. That means it interferes with the neurochemical acetylcholine, which is essential for cognitive function. Symptoms may include dry mouth, constipation, drowsiness, blurred vision, urinary retention and confusion.
While this drug may have been okay for you 20 years ago, it is considered inappropriate for people over 65 and could make memory worsen or even contribute to dementia (JAMA Internal Medicine, March, 2015). This link also holds for people with Parkinson’s disease (PLoS One, online March 3, 2016).
We are sending you our Guide to Drugs and Older People with a discussion of medications like amitriptyline that may cause forgetfulness. In addition to amitriptyline, you will find a discussion of many other drugs that older people should generally avoid. Those who would like a list of drugs with anticholinergic activity will find it here. There is an in-depth discussion of the research here.
We don’t know if gradually withdrawing from amitriptyline will reverse its cognitive effects. We urge you to take the Guide with you when you discuss this with your doctor.