Common Sleep and Allergy Medications Linked to Dementia, Alzheimer’s

You may want to check your medicine cabinet after reading this.

Man holding pill bottleA new study links long-term use of common medications — including over-the-counter drugs for insomnia and hay fever — to a higher risk of dementia, including Alzheimer’s disease. Medications in the study included antihistamines found in Benadryl, sleep aids found in Tylenol PM, and certain antidepressants and treatments for bladder control.

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Dementia risk in older adults starts to rise after three years of regular use of the medications, says study author Shelly Gray, professor of pharmacy at the University of Washington. The longer people took the drugs and the higher the dose, the higher the risk of dementia, although it’s important to note that short-term use was not linked to higher risks.

“We know that these medications may have an effect on memory, and we always assumed that these effects were reversible. We didn’t think these medications were changing the brain permanently. Our study does suggest a link between the highest use and increased dementia risk,” said Gray.

The researchers tracked 3,500 older adults for use of medications with an anticholinergic blocking effect on the nervous system. (The People’s Pharmacy has a  list of generic and brand-name anticholinergic medicines, including common side-effects.)

Medications that act on the brain this way are known to cause short-term problems with cognition and thinking — consider the pervasive “no driving or operating heavy machinery” warnings on the labels — but researchers with the University of Washington and Seattle’s Group Health Research Institute set out to see whether they have a long-term effect as well. They followed subjects for seven years, and used pharmacy records to track both prescription and over-the-counter medication use. The study was published Jan. 26 in JAMA Internal Medicine.

Because trouble sleeping is a common long-term dilemma for older adults, Gray recommended that they “think twice” before choosing over-the-counter sleeping pills and instead first try nondrug therapy for insomnia – such as avoiding sleep at least six hours before bedtime and waking up at the same time every day, even on weekends.

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Gray added that there are alternatives for many of these medications, including Celexa and Prozac for depression, and Claritin for allergies. Most important, she said, people should talk to their doctors about all the medications they are taking, including over-the-counter ones that don’t need a prescription, and make sure they are using the lowest dose for the least amount of time needed to alleviate symptoms. But she stressed that “no one should stop taking any therapy without consulting their health care provider.”

The top 20 drugs used by the study participants, in alphabetical order:
  • Amitriptyline (Elavil)
  • Atropine
  • Chlorpheniramine (Actifed, Allergy & Congestion Relief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc.)
  • Desipramine (Norpramin)
  • Dicyclomine (Bentyl)
  • Diphenhydramine (Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.)
  • Doxepin (Adapin, Silenor, Sinequan)
  • Hydroxyzine (Atarax, Vistaril)
  • Hyoscyamine (Anaspaz, Levbid, Levsin, Levsinex, NuLev)
  • Imipramine (Tofranil)
  • Meclizine (Antivert, Bonine)
  • Nortriptyline (Pamelor)
  • Olanzapine (Zyprexa)
  • Oxybutynin (Ditropan, Oxytrol)
  • Paroxetine (Brisdelle, Paxil)
  • Prochlorperazine (Compazine)
  • Promethazine (Phenergan)
  • Pseudoephedrine HCl/Triprolidine HCl (Aprodine)
  • Scopolamine (Transderm Scop)
  • Tolterodine (Detrol)

 

Photo: cglade/iStock

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32 comments
2Papa
2Papa 5pts

Whew!  I'm glad I don't use any of these pills.

dfwsteph
dfwsteph 5pts

This is another place where I question who and how standards of healthy sleep are defined, along with weight, and for that matter, sanity?


All these rules, but who makes them up and decides whether I'm following them or not? (usually not) 

SSGVern
SSGVern 5pts

But she stressed that “no one should stop taking any therapy without consulting their health care provider.”

In other words TALK TO YOUR DOCTOR

YeshuasFollower
YeshuasFollower 5pts

I take 3 grams Melatonin Extended Release to help me with my sleep.  Melatonin is a naturally occurring substance in the body.  I buy it at the health food store. 

ph3776
ph3776 5pts

I WILL STOP TAKING CHLOR TABS FROM WALMART. 

ACTIVE INGREDIENT CHLORPENIRAMINE 4MG

MAYBE MY MEMORY WILL COME BACK,

I HAVE BEEN TAKING IT FOR YEARS.


johnson5000
johnson5000 5pts

There may be others.  This list was current as of 2013.


First-Generation OTC Antihistamines
  • Brompheniramine (1 brand name: Dimetapp Cold and Allergy Elixir)
  • Chlorpheniramine (1 brand name: Chlor-Trimeton)
  • Dimenhydrinate (1 brand name: Dramamine)
  • Diphenhydramine (2 brand names: Benadryl Allergy, Nytol, Sominex)
  • Doxylamine (2 brand names: Vicks NyQuil, Alka-Seltzer Plus Night-Time Cold Medicine)

bb78588523
bb78588523 5pts

I am one of those "elderly" people that has trouble falling asleep. Thank goodness I live in Colorado.  Rather than pharmaceuticals which often cause unwanted side effects, long and short term, I choose to smoke a bowl of hash at bedtime.. 15 minutes later I'm in la la land, with no ill effects in the morning. It's a great way to drift off to sleep.

Sheila30
Sheila30 5pts

For insomnia, you might try discontinuing your daily vitamin.  I couldn't figure out why could not sleep and then had to discontinue calcium and iron, which are in vitamins, in order to take thyroid medication.  I now sleep like a baby.  Give it a try.

ritaclarke
ritaclarke 5pts

Oh, so you're saying that sleep deprivation's fine.........just don't take meds that my cardiologist and gerontologist said were fine to help me sleep. And this was AFTER I'd been deprived of sleep over many months.   BOY!!!   What useless information!!!

barbsharon
barbsharon 5pts

You mention two different antihistimines, Benedryl, which is diphenhydramine, and ChlorTimeton, which is chlorpheniramine maleate.  Which one was in the study?  

craigbovia
craigbovia 5pts

Take nothing unless you absolutely need it.  Big Pharma is focused on your wallet.  Your health is an anecdote.  Can anyone name an Amerikan Korporation they really Trust???

dd6904
dd6904 5pts

Interesting; but what good are these reports if you do not list the  brand name or description a customer would recognize. You, like most liberal organizations love to put the carrot out there, and never allow one to finsih the last bite.

KENETICS
KENETICS 5pts

I resolve to Vote Republican for the rest of my life.

mr9735
mr9735 5pts

I did not see a list of the medications or a link to locate a list. Can you publish or clarify that, please?

CarryAnne
CarryAnne 5pts

Agreed. A single dose of an antihistamine prescribed by a doctor put me in the hospital with severe dehydration and a manic sleeplessness. However, sleeplessness is all so very complicated by the ubiquitous nature of fluoride in our water, foods, and medications. 

Fluoride is the most reactive element, so it is often added to medications to give them additional punch. Fluoride is also a "potent adjuvant" (causes or worsens allergic reactions), a "proliferative agent" (causes inflammation) and a known toxin that crosses the brain barrier. At least 50% of the fluoride a person ingests is permanently stored in bones, where it is known to cause brittleness and arthritic symptoms. Per 2006 NRC, “fluoride is likely to cause decreased melatonin production," i.e. contribute to sleeplessness, 

In a 2014 study, 100% of community water fluoride additives were contaminated with ALUMINUM, to which it also binds strongly, which is why many people stopped using aluminum pans. Samples were also contaminated with arsenic and lead. Fluoride also leaches lead out of pipes. Consequently, fluoridated water is in effect a delivery system of aluminum and lead into our bones and brains..... no wonder seniors who have been drinking fluoridated water for decades have problems sleeping and thinking clearly! 

bc79048022
bc79048022 5pts

This is an article -- and study -- that are long past-due.  Kudos to Ms. Agnvall and her research for always cutting directly to the crux of crucial matters.  I for one will be much more alert to even short-term prescriptions issued to me by an MD or PA.   Many thanks to AARP for keeping such results and alerts before us, making us more proactive and conscious of what we can do to protect ourselves and loved ones from avoidable illness.

bagnvall
bagnvall 5pts

@dfwsteph Re: rules about sleep. The National Sleep Foundation has released new guidelines, including age-specific regulations, on how much sleep people need. Candy Sagon wrote a nice blog on it that you can see here: How Much Sleep Do You Really Need?

http://blog.aarp.org/2015/02/03/how-much-sleep-do-you-really-need/

“This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety,” Charles Czeisler, M.D., chairman of the board of the National Sleep Foundation.

bagnvall
bagnvall 5pts

@SSGVern Yes, that's right. Thanks for your comment. No one should ever stop taking medication without talking to his or her doctor. Also, be sure to note that this study found that dementia risk in older adults started to increase after three years of regular use of the medications. The risks didn't rise from occasional use to treat, for example, a cold or allergy, even people took those medications for several weeks. Betsy Agnvall (the writer)

bagnvall
bagnvall 5pts

@ritaclarke  Actually, researchers are finding that sleep is incredibly important for brain health. Sleep deprivation is tied to cognitive decline, memory loss and possibly Alzheimer's. 

During sleep the brain clears out toxins, repairs daily wear-and-tear and makes new memories. 

AARP The Magazine just published a recent piece, Why Sleep Is Important for Brain Health, that has the newest research explained by P. Murali Doraiswamy, M.D., a renowened brain researcher at Duke University in Durham, N.C., You can see it here:

http://www.aarp.org/health/brain-health/info-2014/sleep-for-brain-health.html.

What we don't know is whether using sleep medication to improve sleep allows the brain to do what it needs to do during sleep. Betsy Agnvall (AARP brain health blog writer)

InsertCleverNameHere
InsertCleverNameHere 5pts

@ritaclarke Sounds like it's time for you to find new doctors who stay up to date on the latest studies.  A doctor I met who specializes in sleep medicine had me read a book called Say Goodnight To Insomnia.  In it, the author provides evidence that  there is no such thing as a "safe" sleep aid--prescription or over-the-counter.  He also presents proof that sleep aids are generally not effective and that any perceived benefit is likely due to the placebo effect.  Also, the latest research shows that sleep deprivation is not nearly as harmful as drug companies would have you believe.  Worst case is you might be a little cranky the next day.  Long-term health problems due to sleep deprivation are pretty much non-existent.

bagnvall
bagnvall 5pts

@barbsharon  Both of those are anticholinergic medications, so they are both included in the study. Betsy Agnvall (the writer)

bagnvall
bagnvall 5pts

@dd6904 Thanks for your comment dd6904. We've now included a link to brand and generic names of the class of medications described in the study. Just look at the bottom of the blog. Betsy Agnvall (the writer)

behrhorn
behrhorn 5pts

@dd6904  WTF, its because the repub filled lawyer lobby that is so quick to sue.  Be responsible for you own actions and live a healthy life free of meds.

elabraham
elabraham 5pts

@dd6904  I don't know about you, but as a long-time allergy sufferer - I know the name of the ingredient for each of my OTC meds, not just the brand name, so I can choose generics and store brands

InsertCleverNameHere
InsertCleverNameHere 5pts

@KENETICS Go ahead, but you're shooting yourself in the foot since Republicans want to do away with Medicare and Social Security.  At the very least they will reduce benefits since Republicans wrongly assume that doing so will have an impact on the economy.

CarryAnne
CarryAnne 5pts

P.S. Re permanent changes to brains caused by seemingly innocuous medications: there are 20 years of animal and human studies linking in utero or youthful ingestion of fluoride to neuro-deficits, like reduced memory and ADD. The latest done by Harvard School of Public Health is just out, and is conducted with in a community with "optimal" fluoridation, i.e. 1 mg/L or 1 ppm fluoride levels in water: 

2015  in Neurotoxicology and Teratology. Association of lifetime exposure to fluoride and cognitive functions in Chinese children: A pilot study.

http://www.ncbi.nlm.nih.gov/pubmed/25446012

http://braindrain.dk/2014/12/mottled-fluoride-debate/

2014 in Physiology and Behavior. Fluoride exposure during development affects both cognition and emotion in mice. 

http://www.ncbi.nlm.nih.gov/pubmed/24184405


The first study from 1995: http://www.ncbi.nlm.nih.gov/pubmed/7760776

bagnvall
bagnvall 5pts

@bc79048022 Thanks for the kind words bc79048022. Always appreciated! Betsy Agnvall

InsertCleverNameHere
InsertCleverNameHere 5pts

@bb78588523 @InsertCleverNameHere @ritaclarke The author of the book, Dr. Gregg Jacobs, is a Harvard professor who has studied sleep disorders for decades and successfully treated over 10,000 insomnia patients.  Jacobs says. "We place an emphasis on their worries and anxieties about how their insomnia will affect their next-day performance and long-term health. We educate them about research showing that in most cases their concerns are not accurate." http://www.webmd.com/sleep-disorders/news/20040927/short-insomnia-therapy-beats-sleeping-pills