Risks vs. Benefits: Information About Your Medications No One Talks About, Until Now

Updated: Jun 28


Coming across an article the other day sent my head spinning.  As a nurse who has spent years working with individuals with Alzheimer’s and dementia, also with losing a family member to the disease, I was outraged.  Smoke pouring out of my ears is a statement that doesn’t even come close to how I felt. 


                To my complete horror, a report that medications produced by pharmaceutical companies have been shown to cause (or highly increase the likelihood of acquiring) dementia.  You can imagine my shock in finding out that studies on these medicines, both prescription and over the counter medications, had been out for years and yet, the drugs are still in use.


               According to an article from June 14, 2018:

“In two separate large population studies, both benzodiazepines and anticholinergic medications were associated with an increased risk of dementia in people who used them for longer than a few months.”

            Added to that are two more classifications of medications.  Non-benzodiazepine sleep aides, and antipsychotic/mood stabilizing drugs.  Correct me if I’m wrong, but should that be included in the patient information of the risks and benefits?


I will be listing medications that fall into these categories soon, don’t worry.


                In an article written by Dr. Leslie Kernisan, MD MPH, she states:

“What especially troubles me is that most older adults (and their families) have no idea that many [referring to the medications] have been linked to developing dementia, or to worsening dementia symptoms.”

          How is that even possible?  Doesn’t your doctor have a “duty to warn” you about potential side-effects or adverse reactions a medication may cause?  How it is possible that the manufacturer of that medication doesn’t have to list DEMENTIA as a potential side effect on the bottle?


           Have you ever seen it?  Information about potentially inappropriate medications can be found at the AGS Beers report.


                I haven’t either!


So, without further ado, let’s get down to the facts, the studies that have shown how damaging these FDA approved medications are.


A Study of Anticholinergic Medications:


                The first study done on anticholinergic meds included reviewing medical records to see the length of time individuals has been on any of the medications that fell into the classification over a 10-year period. 


Included in the study were nearly 3,500 men and women ages 65 and over, and they tracked them for seven years from the time the study started.  By the end of the seven years, 800 out of the 3,500 men and women had developed dementia.


The examiners of the experiment found that individuals who took anticholinergic medications for over 3-years had a 54% higher chance of developing dementia than those who didn’t, and the longer you took the med, along with the strength of the dose increased your likelihood.    


Now, the adverse effects of anticholinergic medications include dry mouth, blurry vision, constipation, drowsiness, sedation, hallucinations, memory problems, trouble urinating, confusion, delirium, decreased sweating, decreased saliva.


A Benzodiazepine Study:


                A group of Canadian and French researchers connected benzos to an increased risk of developing Alzheimer’s and dementia which also depends on the length of use and strength of dose.


The real kicker here is that the usage time of these medications is drastically shorter than the usage of the anticholinergic class before the risk of dementia is increased.


                The team was granted access to health insurance information for this study.  Researchers identified around 2,000 men and women who had previously been diagnosed with Alzheimer’s or dementia.  Then they randomly selected over 7,000 others who had not be diagnosed with the disease, based on data they collected from the group of 2,000. 


                The research team examined the previous 6 years of these individuals before their development of Alzheimer’s or dementia.  The shocking truth is that anyone who took a benzodiazepine for as little as 3 months in a row had the same risk as those who had only used it for just one month.


                For those who had taken a benzo medication for three to six months, there was a 32% increased chance of developing dementia, and those who had used the med(s) for six months or longer were at an 84% increased risk than those who had not.


                This is staggering information.  I don’t know about you, but I know quite a few people who have been on any one of these medications for much longer than 6 months.  To add fuel to the fire, long-acting medications increased the risk even higher than the short-acting benzo class meds.


Non-Benzodiazepine Sleep Aides and Dementia:


This class of medications has been dubbed the “Z-drugs” as their generic name either starts with a Z or a Z sound.  There are three categories within this class of medications.


 For this study, researchers used a population-based case-control study.  Individuals age 65 and older already diagnosed with dementia and Alzheimer’s disease after 2006 were categorized as one group.  They were screened to determine if there could be any other possible reason for the development of the disease.  Any patient who has previously suffered a stroke, head trauma, or other neurological disorder affecting cognition was excluded from the study.  Approximately 8,406 patients with dementia were chosen.  An additional 16,812 individuals were also selected as control subjects.


In a 3-week clinical trial, 2% of patients revealed psychomotor retardation in the group given “z” drugs and 0% in patients who received a placebo. 


Now, some of you may look at that and think, it’s only 2%, but I ask you to consider this:


                In 3 weeks of use 336.24 out of 16,812 were affected by taking this class of medications, once a day.  That’s it, one pill at night for 3 weeks.  Now imagine that study is extended over the course of several months.  I’m willing to go out on a limb and say that percentage increases considerably.  The increased risk of dementia in patients who take this class of medications increases still if they also have underlying conditions including hypertension, diabetes, and/or have had at least one stroke in the past.


                Another study showed that individuals who “z” meds showed significant balance and cognition impairments when they woke up after taking this med the night before.  That’s after one night’s use!!!! 


Antipsychotic Medication and Risk Factors for Dementia:


                Mental illness is a rampant epidemic here in the United States of America.  The staggering numbers as of 2016 show that 1 in every 6 Americans was on some type of psychiatric medication.  These include antidepressants, anti-anxiety, and antipsychotic medications. 


                So, let me get this right, the medications that are prescribed to help relieve unwanted symptoms of depression, anxiety, and psychotic episodes also eat through the brain to leave us with dementia-like symptoms.  Well, no wonder people feel better when they take them.  Hard to feel much when your mind is deteriorating.


                In 2011, a report came out stating that 1 in 10 adult Americans (reporting long-term usage) was on some type of prescription medications because they “could not cope with emotions, nerves, or were experiencing some type of self-diagnosed mental health problem.”   In 2013, it was reported that nearly 17% of all adults in the U.S. filled at least one prescription for some type of psychiatric medication.


                The side effects of these types of medications far surpass just that they play a leading role in the development of dementia with increased dose and usage, but they extend to things like sedation, weakness, unsteadiness, a feeling of depression, loss of orientation, confusion, irritability, aggression, and sleep disturbances.


But Wait, There’s More


The fifth class of medications that can be linked to dementia-like symptoms!!!


Anyone thinking about opioid medications????


Unlike the other medications in the above, this category (aside from Tramadol) is not liked on the Beers list.  

With any usage opiate medications cause changes in cognition, and as the length of time used increases, so does that cognitive impairment.  Not to mention the risk of dependency. 

In the opiate category, you have pain meds, sedatives, hypnotics, anxiolytics, and stimulants. 


Effects of opiate pain meds for short-term use include mood changes, depression, drowsiness, and impaired memory, judgment and attention.  However, neurological symptoms of long-term use include the short-term symptoms but also tolerance, dependence, and addiction.


Neurological effects of sedatives, hypnotics, and anxiolytics include mood swings, inappropriate aggressive or sexual behavior, memory and attention problems, disorientation, impaired cognition, drowsiness or stupor, and coma.  With long-term use, there is also the risk of dependence, tolerance, and addiction.  Withdrawal associated with benzodiazepines is like detoxing for alcoholics, in that, one may suffer seizures, delirium and possibly even death.


Then there are the neurological effects of stimulants.  These include paranoia, anger, agitation, seizures, reduced sleep, and lack of interest in eating.  If these medications are stopped suddenly additional symptoms, include: cravings can kick in and cause the individual to suffer unnecessary fiending created by dependence on it.


It’s Time to Get a Closer Look at These Categories





The above lists are far from complete, more information on these categories and the drugs contained in them can be found by clicking on the link at the bottom of each column.


A Few More Facts You Should Probably Know.


Benzodiazepines and non-benzos are pharmacodynamically the same, and their results are similar in nature.  Meaning they have the related benefits, risks, and adverse effects.  However, that’s where the similarities end.  They are entirely different in their chemical structure and therefore, molecularly unrelated.  Both classes show an affinity for the a1 hypnotic-inducing site one the GABA-A receptors that include sub-units alpha-1, alpha-2, alpha-3, and others.  And while benzodiazepine isn’t picky about with alpha is wants, non-benzos seems to want to only bind to the alpha-1 as that shows to be the receptor that is most closely linked to sleep.


                So, let’s just back up a bit.  We have established that there is a large amount of the population that takes anyone (or multiple) of the medications mentioned throughout, but did anyone stop to look at the additional side effects?  Adult Americans aren’t the only people who take these medications, children have also been prescribed these medications.  If you just skimmed through, as most people do, there is a good chance you missed an essential element, unrelated to dementia and Alzheimer’s disease.  We forget how prevalent pain disorders and mental health disorders are among both adults and children in this day and age.


                I won’t tell you my personal beliefs on that subject, but feel free to leave comments with your thoughts.  A quick side note, during the process of researching for this piece, I discovered different articles that talked about how dementia and Alzheimer’s disease can be reversible. Also, there are treatments available for many of the conditions treated by the medication classes mentioned above, that do not cause all these unwanted side effects. 


                During research for another article, it was made abundantly clear that doctors expect patients to do their own investigation into medications if they want to have a greater understanding.  Well ok, but did you see anywhere in the list of symptoms mentioned above that said, “May Cause Dementia and Alzheimer’s disease if you take unnamed med for X amount of time?”  I sure didn’t see that.  What I did see listed were a little confusion and memory difficulties.  If that is how "will create Alzheimer's disease and dementia symptoms," is stated then the people who take these types of medications are in big trouble.  How are we, the people, supposed to make that kind of jump and be ready to ask more in-depth questions? 


                Doesn’t it seem a little funny that these are even still available?  It’s as if we are being told:

“it’s ok to lose your faculties, as long as you can hold your bladder, free yourself from pain, have no allergies, and walk around like a zombie.” 

Come on people, please tell me you see how wrong that is?


Please leave your comments below and feel free to subscribe to this blog.  New articles aren’t posted daily, they do take time because of the amount of research that goes into each one.  However, if you are interested, subscribing will ensure you are notified when something new does go up.


                We look forward to reading and responding to your comments.




References:


American Geriatrics Society. (2015, October). AGS BEERS. Retrieved from HealthinAging.org: http://www.healthinaging.org/medications-older-adults/


Barkin., R. H.-I., Lin, C.-C., Tu, Y.-F., Chang, C.-M., Hsu, H.-C., Chi, C.-H., & Kao, C.-H. (2015). An Increased Risk of Reversible Dementia May Occur After Zolpidem Derivatitive Use in the Elderly Population: A Population-Based Case-Control Study. Medicine, Volume 94/ Issue 17/ p. e809.


Casey, D. (2015, April). Pharmacotherapy of Neuropsychiatric Symptoms of Dementia. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378522/


Frey, D., Ortega, J., Wiseman, C., Farley, C., & Wright, K. (2011). Influence of Zolpidem and Sleep Inertia on Balance and Cognition During Nighttime Awakening: A Randomized Placebo-Controlled Trial. American Geriatrics Society, 73-81.


Harvard Women's Health Watch. (2018, Jun 14). Two types of drugs you may want to avoid for the sake of your brain. Retrieved from Harvard Health Publishing, Harvard Medical School: https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain


Kernisan, L. (2018, August 27). 4 Types of Brain-Slowing Medication to Avoid if You're Worried About Memory. Retrieved from Better Health While Aging: https://betterhealthwhileaging.net/medications-to-avoid-if-worried-about-memory/


Miller, S. (2016, December 13). 1 in 6 Americans Takes a Psychiatric Drug. Retrieved from Scientific American: https://www.scientificamerican.com/article/1-in-6-americans-takes-a-psychiatric-drug/


Mischoulon, D. (2009, December). Update and Critique of Natural Remedies as Antidepressant Treatments. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786903/


Ogbru, A., & Marks, J. (n.d.). Benzodiazepines. Retrieved from RxList: https://www.rxlist.com/benzodiazepines/drugs-condition.htm#examples


Talcherkar, A. (2018, January 22). How Do Prescription Drugs Affect the Brain. Retrieved from detox: An American Addiction Centers Resource: https://www.detox.net/prescription-drugs/effects-on-brain/


The Doctors Company. (2013, February). When Prescribing Drugs, a Physician Has a Duty to Warn Patients. Retrieved from The Doctors Company: https://www.thedoctors.com/articles/when-prescribing-drugs-a-physician-has-a-duty-to-warn-patients/

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