- New research has found a significant link between anticholinergic drugs – including common antidepressants– and risk of dementia in the long term.
- Daily use of one of these drugs for three months or more likelihood of diagnosis, particularly for middle-aged and elderly patients.
- Anticholinergic drugs are used to help manage muscle spasms and involuntary movements by blocking a certain brain chemical. Not all of them are related to dementia risk.
- The study added to the body of research finding links, between the drugs and dementia. More research is needed to fully understand the connection.
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TO new study of more than 283,000 elderly people in the U.K. has found that long-term use of anticholinergic drugs – including some medications for depression, epilepsy, and Parkinson's disease – is associated with a significant increased risk of dementia.
Researchers at the University of Nottingham, U.K., tracked more than 58,000 with dementia and 225,000 people without it. The time period was diagnosed with dementia.
The researchers who participated in the project, who took even one strong anticholinergic drug at the minimum effective daily dose for three years had a 50% greater likelihood of being diagnosed with dementia, even taking not they smoked or drank alcohol. 80, suggesting that middle-aged and elderly people should be even more cautious about their medications.
The study authors do not say that people should stop taking anticholinergic medications. Rather, they recommend doctors to weigh the pros and cons of these drugs before prescribing them, and to consider alternative treatment options when possible, particularly when they are in middle age and beyond.
"Anticholinergic drugs" are a common class of drugs that block specific brain chemical, and not all are implicated in dementia risk
Overall, the study included 56 anticholinergic medications. The term describes a class of drugs used to help manage muscle spasms and other involuntary muscle movements. The drugs work by blocking a specific neurotransmitter, acetylcholine, that the brain uses to tell muscles in the lungs, gastrointestinal tract, urinary tract, and other areas of the body to contract. As a result, people can improve digestive, urinary, and other types of functioning when on the drugs.
Some antidepressants, epilepsy drugs, and medications used to control anticholinergic drugs They include:
Antidepressants like amitriptyline, paroxetine, nortiptyline, and doxepin
Antiepileptics like carbamazepine and oxcarbazepine
Antipsychotics like quetiapine, olanzapine, chlorpromazine, and perphenazine
Drugs for Parkinson's disease like benztropine, orphenadrine, and trihexyphenidyl
Medications for bladder control including darifenacin, fesoterodine, oxybutynin, and tolterodine
However, not all types of anticholinergic drugs included in the study were implicated in demetia risk, however. Researchers found no correlation between dementia rates and other anticholinergic medications, including:
Antihistamines like diphenhydramine and hydroxyzine
Gastrointestinal antispasmodics like dicyclomine and hyoscinepropantheline
Antimuscarinic bronchodilators like ipratropium
Antiarrhythmics like disopyramide
Skeletal muscle relaxants like tizanidine and methocarbamol
This is not the first study finding to link anticholinergics and dementia, but more research is still needed
These findings are supported by previous research on possible correlations between dementia and anticholinergics. Past studies included smaller group of patients, and focused on short-term exposure to drugs but had a similar result: a significant increase in risk of dementia associated with anticholinergics.
Some of the following conditions treated by anticholinergics, like depression, have their own links to dementia, so it’s hard to understand whether it’s the illnesses, the drugs that treat them, both, or something else that’s to blame.
However, the study’s authors theorise that if a causal link could have been related to more than 10% of diagnosis could be attributable to anticholinergic exposure. Physical inactivity (6.5%), midlife hypertension (5%), and diabetes (3%).
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