June 14, 2015

June 14, 2015
10 Drugs that May Cause Memory Loss
Part 2


Welcome to another day in my life. Today is Sunday and I hope you had a beary safe and great weekend so far. Dab the AIDS Bear is on the road doing events again this weekend while you're enjoying yours.

Memory loss is normal to some extent as we age but did you know there are also medications which can cause memory loss. I started blogging about this issue yesterday so read it first.

6. Parkinson's drugs (Dopamine agonists)

Why they are prescribed: These drugs are used to treat Parkinson's disease, certain pituitary tumors and, increasingly, restless legs syndrome (RLS).

Examples: Apomorphine (Apokyn), pramipexole (Mirapex) and ropinirole (Requip).

How they can cause memory loss: These meds activate signaling pathways for dopamine, a chemical messenger involved in many brain functions, including motivation, the experience of pleasure, fine motor control, learning and memory. As a result, major side effects can include memory loss, confusion, delusions, hallucinations, drowsiness and compulsive behaviors such as overeating and gambling.

Alternatives: If you are being treated for RLS, ask your doctor or pharmacist whether one of your prescription or over-the-counter medications may be the trigger. Potential culprits include many antinausea and antiseizure medications, antipsychotic drugs with tranquilizing effects, some antidepressants, and some cold and allergy medications. In this case, your RLS and memory problems could potentially be resolved by simply replacing the offending medication with another drug.

7. Hypertension drugs (Beta-blockers)

Why they are prescribed: Beta-blockers slow the heart rate and lower blood pressure and typically are prescribed for high blood pressure, congestive heart failure and abnormal heart rhythms. They're also used to treat chest pain (angina), migraines, tremors and, in eyedrop form, certain types of glaucoma.

Examples: Atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), propranolol (Inderal), sotalol (Betapace), timolol (Timoptic) and some other drugs whose chemical names end with "-olol."

How they can cause memory loss: Beta-blockers are thought to cause memory problems by interfering with ("blocking") the action of key chemical messengers in the brain, including norepinephrine and epinephrine.

Alternatives: If the beta-blocker is being used to treat glaucoma, I recommend talking with your health care professional about potentially using a carbonic anhydrase inhibitor, such as dorzolamide (Trusopt), instead. 8. Sleeping aids (Nonbenzodiazepine sedative-hypnotics)

Why they are prescribed: Sometimes called the "Z" drugs, these medications are used to treat insomnia and other sleep problems. They also are prescribed for mild anxiety.

Examples: Eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien).

How they can cause memory loss: Although these are molecularly distinct from benzodiazepines (see No. 1 above), they act on many of the same brain pathways and chemical messengers, producing similar side effects and problems with addiction and withdrawal.

The "Z" drugs also can cause amnesia and sometimes trigger dangerous or strange behaviors, such as cooking a meal or driving a car with no recollection of the event upon awakening.

Alternatives: There are alternative drug and nondrug treatments for insomnia and anxiety, so talk with your health care professional about options. Melatonin, in doses from 3 to 10 mg before bedtime, for instance, sometimes helps to reestablish healthy sleep patterns.

Before stopping or reducing the dosage of these sleeping aids, be sure to consult your health care professional. Sudden withdrawal can cause serious side effects, so a health professional should always monitor the process.

9. Incontinence drugs (Anticholinergics)

Why they are prescribed: These medications are used to relieve symptoms of overactive bladder and reduce episodes of urge incontinence, an urge to urinate so sudden and strong that you often can't get to a bathroom in time.

Examples: Darifenacin (Enablex), oxybutynin (Ditropan XL, Gelnique, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). Another oxybutynin product, Oxytrol for Women, is sold over the counter.

How they can cause memory loss: These drugs block the action of acetylcholine, a chemical messenger that mediates all sorts of functions in the body. In the bladder, anticholinergics prevent involuntary contractions of the muscles that control urine flow. In the brain, they inhibit activity in the memory and learning centers. The risk of memory loss is heightened when the drugs are taken for more than a short time or used with other anticholinergic drugs.

A 2006 study of oxybutynin ER, for example, found its effect on memory to be comparable to about 10 years of cognitive aging. ("In other words," as the study's lead author put it, "we transformed these people from functioning like 67-year-olds to 77-year-olds.")

Older people are particularly vulnerable to the other adverse effects of anticholinergic drugs, including constipation (which, in turn, can cause urinary incontinence), blurred vision, dizziness, anxiety, depression and hallucinations. Alternatives: As a first step, it's important to make sure that you have been properly diagnosed. Check with your doctor or other health professional to see if your urinary incontinence symptoms might stem from another condition (such as a bladder infection or another form of incontinence) or a medication (such as a blood pressure drug, diuretic or muscle relaxant).

Once these are ruled out, I'd recommend trying some simple lifestyle changes, such as cutting back on caffeinated and alcoholic beverages, drinking less before bedtime, and doing Kegel exercises to strengthen the pelvic muscles that help control urination.

If these approaches don't work out, consider trying adult diapers, pads or panty liners, which can be purchased just about anywhere. They can be worn comfortably (and invisibly) under everyday clothing and virtually eliminate the risk of embarrassing accidents. In my experience, many patients are reluctant to try this approach, but once over the initial hurdle, come to prefer it for security and peace of mind.

Correction: An earlier version of this blog mistakenly implied that mirabegron (Myrbetriq), which the FDA approved last year for the treatment of overactive bladder, is an anticholinergic drug; in fact, it is in a new class of medications called beta-3 adrenergic agonists and is not expected to cause memory loss seen with anticholinergic medications. There currently are no data describing the effect of Myrbetriq on cognition.

10. Antihistamines (First-generation)

Why they are prescribed: These medications are used to relieve or prevent allergy symptoms or those of the common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting and dizziness, and to treat anxiety or insomnia.

Examples: Brompheniramine (Dimetane), carbinoxamine (Clistin), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl) and hydroxyzine (Vistaril).

How they can cause memory loss: These medications (prescription and over-the-counter) inhibit the action of acetylcholine, a chemical messenger that mediates a wide range of functions in the body. In the brain, they inhibit activity in the memory and learning centers, which can lead to memory loss.

Alternatives: Newer-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are better tolerated by older patients and do not present the same risks to memory and cognition.

Hope these tips help you keep your memory strong into your late years and you have a beary safe and great Sunday!

Until we meet again; here's wishing you health, hope, happiness and just enough.



big bear hug,







Daddy Dab