Many people over age 65, and even younger, are on multiple medications. I have even seen people on 15-20 different medications. Several types of medications make memory worse and should be stopped if possible, or if it is not life-threatening to stop them.
The first class of medications are called anticholinergics. The “cholinergic” part of the word means that it interacts with the neurotransmitter acetylcholine. The “anti” part of the word means that it blocks acetylcholine. This neurotransmitter acetylcholine is responsible for staying alert, processing information, and making new memories. In fact, the main medication for helping people with Dementia is donepezil (brand name Aricept), and the way it helps people stay alert, process new information, and form new memories is through its ability to boost acetylcholine. So you can see that taking anticholinergics may deplete a person’s memory, slow their information processing, and have trouble remembering. Thus it is best to avoid these. These are the anticholinergics commonly being used:
-Over the counter sleep aides such as Unisom or anything containing doxylamine, such as Nighttime Cold Medicine, or anything PM.
-Prescription sleep aides such as mirtazipine (brand name Remeron) and trazodone (brand name Desyrel)
-Prescriptions medications for anxiety such as doxepin (Sinequan) and hydroxyzine (Vistaril)
-Diphenhydramine (brand name Benadryl) for allergies
-Amitryptilene (brand name Elavil) for migraines or depression
-Paroxetine (brand name Paxil) for depression or anxiety
-Drugs for urinary symptoms such as oxybutinin (brand name Ditropan), solifenacin (Vesicare)
-Anticholinergic inhalers, such as Ipratropium, Spiriva, or Atrovent
The next class of medications to avoid are benzodiazepines. These work by boosting a neurotransmitter called GABA which shuts all brain activity down. These should be tapered off, if possible, and include:
-Temazepam (brand name Restoril)
-Alprazolam (brand name Xanax)
-Lorazepam (brand name Ativan)
-Clonazepam (brand name (Klonopin)
-Diazepam (brand name Valium)
There are also medications that work like benzodiazepines and are best to avoid:
-zolpidem (brand name Ambien)
-eszopiclone (brand name Lunesta)
It is also best to avoid antipsychotics and some depression medications because they deplete dopamine in the brain (which is responsible for motor movement, motivation, and processing speed. So, taking these medications may cause a person to actually have parkinsonism (tremor, slowness, balance issues), trouble getting motivated to do things, and fall. These include:
-haloperidol (brand name Haldol)
-aripiprazole (brand name Abilify)
-quetiapine (brand name Seroquel)
It is also best to avoid medications that sedate a person, such as:
-Opiates (such as Tramodol (brand name Ultram), Percocet, oxycodone, morphine)
A lot of people ask me about their blood pressure and cholesterol medications. We think that blood pressure agents that are some beta-blockers deplete the focusing and processing neurotransmitters in the brain. These include:
-metoprolol (brand name (Lopressor)
-propranolol (brand name Inderal)
-labetalol (brand name Normodyne)
We also think that some cholesterol medications go into the brain and deplete the cholesterol in the brain cells, which is important for information processing. There are many types of cholesterol medications. The ones that go into the brain, and that I recommend avoiding, are:
-Atorvastatin (brand name Lipitor)
-Simvastatin (brand name Zocor)
There are many alternatives to these medications if you have high blood pressure, high cholesterol, insomnia, depression, or anxiety. It is best to see a cognitive specialist to advise your medical team about the optimal medication.
For a list of medications to avoid, and possible alternatives, please also see this website from Harvard.
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