For a long time, doctors believed that forgetfulness and mental confusion were normal signs of aging. But scientists now know that memory loss is inevitable as we age. Indeed, the brain can grow new brain cells and reshape their connections throughout life.
Most people are aware of some things that can impair memory, such as alcohol and drug abuse, heavy smoking, head injury, stroke, insomnia, severe stress, vitamin B12 deficiency, Alzheimer’s disease, and depression.
But what many people don’t know is that many common prescription drugs can interfere with memory. Here are the top 10 types of criminals.
- Anti-anxiety drugs (benzodiazepines)
Why they are prescribed: Benzodiazepines are used to treat various anxiety disorders, agitation, delirium, muscle spasms, and to prevent seizures. Because benzodiazepines are sedatives, they are sometimes used to treat anxiety that accompanies insomnia and depression.
Examples include alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan), midazolam (Versed), quazepam (Doral), temazepam (Restoril), and triazolam ( H) ).
Drugs that cause memory loss
- Anti-anxiety drugs
- Cholesterol drugs
- Anti-seizure drugs
- Antidepressant drugs
- Narcotic pain relievers
- Parkinson’s drugs
- Medicines for high blood pressure
- Sleeping equipment
How they can cause memory loss: Benzodiazepines reduce activity in key areas of the brain involved in transferring events from short-term memory to long-term memory. In fact, benzodiazepines are used for anesthesia for this very reason. When added to the anesthesiologist’s cocktail of medications, patients rarely recall any discomfort from the procedure. Midazolam (Versed) has special properties.
Alternatives: Benzodiazepines should be used sparingly and, in my opinion, for short periods in the elderly. Older people take much longer to clear these drugs from their bodies than younger people, and as a result, older people are at greater risk of memory loss, delirium, falls, fractures, and motor vehicle accidents.
If you are taking one of these medications for insomnia, mild anxiety, or anxiety, talk to your doctor or other health care professional about treating the condition with other medications or non-drug treatments. If you have insomnia, for example, melatonin can help. When taken in doses of 3 to 10 mg before bedtime, melatonin can help restore healthy sleep patterns.
Consult your healthcare professional before stopping or reducing the dose of a benzodiazepine. Abrupt withdrawal can trigger serious side effects, so a healthcare professional should always monitor the process.
- Cholesterol-lowering drugs (statins)
Why they are prescribed: Statins are used to treat high cholesterol.
Examples include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).
How they can cause memory loss: Cholesterol-lowering drugs can impair memory and other mental processes by lowering cholesterol levels in the brain. In the brain, these lipids are important for building connections between neurons, which are the main link between memory and learning. (The brain actually contains a quarter of the body’s cholesterol.)
A 2009 study published in the journal Pharmacotherapy found that three out of four people who take these drugs experience adverse cognitive effects. The researchers reported that 90 percent of patients who stopped taking statins experienced improvements in cognitive function, sometimes within days. In February 2012, the Food and Drug Administration ordered drug companies to add a warning label to the prescribing information for statins about potential memory problems.
Alternatives: Ask your doctor or other health care provider if you’re taking these drugs to treat slightly elevated LDL (“bad”) cholesterol and low HDL (“good”) cholesterol among older Americans without coronary artery disease. Instead, doctors recommend a combination of sublingual (under the tongue) vitamin B12 (1000 mcg daily), folic acid (800 mcg daily) and vitamin B6 (200 mg daily).
- Anti-seizure drugs
Why they’re prescribed: Long used to treat seizures, these drugs are increasingly being used for nerve pain, bipolar disorder, depression, and mania.
Examples: Acetazolamide (Diamox), carbamazepine (Tegretol), ezogabine (Potiga), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), pregabalin (Lyrica), rufinamide (Tozeliramate) (B) , ), valproic acid (Depakote) and zonisamide (Zonegran).
How they can impair memory: Anticonvulsants are thought to limit seizures by weakening the flow of signals within the central nervous system (CNS). All drugs that suppress signaling in the central nervous system can cause memory loss.
Alternatives: Many seizure patients do well with phenytoin (Dilantin), which has little effect on memory. Many patients with chronic nerve pain find that the memory aid venlafaxine (Effexor) relieves pain.
- Antidepressant drugs (tricyclic antidepressants)
Why they’re prescribed: TCAs are indicated for depression, generalized anxiety disorder, eating disorders, obsessive-compulsive disorder, chronic pain, smoking cessation, and certain hormonal disorders, such as severe menstrual cramps and hot flashes. .
Examples include amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpamine), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil).
How they may affect memory loss: About 35 percent of adults taking TCAs report poor memory, and about 54 percent report difficulty concentrating. TCAs are thought to cause memory problems by blocking the brain’s main chemical messengers, serotonin and norepinephrine.
Alternatives: Talk to your healthcare provider about whether non-drug treatments might be better or more effective for you than drugs. You may want to lower the dose (side effects of antidepressants are often dose-related) or switch to a selective serotonin/norepinephrine inhibitor (SSRI/SNRI). I believe that venlafaxine (Effexor) has the fewest side effects in older patients of this class of drugs.
- Narcotic pain relievers
Why they’re prescribed: These drugs, called opioid pain relievers, are used to relieve moderate to severe chronic pain, such as pain caused by rheumatoid arthritis.
Examples include: Fentanyl (Duragesic), hydrocodone (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo), morphine (Astramorph, Avinza), and oxycodone (OxyContin, Percocet). These medications come in many different forms, including tablets, injectable solutions, transdermal patches, and suppositories.
How they can impair memory: These drugs work by stopping the flow of pain signals in the central nervous system and suppressing the emotional response to pain. Both of these actions are mediated by chemical messengers involved in multiple cognitive functions. Therefore, the use of these drugs can interfere with long-term and short-term memory, especially with long-term use.
Alternatives: Non-steroidal anti-inflammatory drugs (NSAIDs) are the preferred treatment for pain in patients under 50 years of age. Unfortunately, NSAID therapy is not suitable for elderly patients with a high risk of gastrointestinal bleeding. Studies have shown that the risk increases depending on the dose and duration of treatment.
Talk to your doctor or other health care provider about whether tramadol (Ultram), a non-narcotic pain reliever, might be a good choice for you. In my practice, I recommend supplementing each 50 mg dose with 325 mg of acetaminophen (Tylenol) tablets. There are prescription medications that combine tramadol and acetaminophen, but these products only contain 37.5 mg of tramadol, and in my practice, I have found that patients often need higher doses.
- Parkinson’s drugs (Dopamine agonists)
Why they’re prescribed: These drugs are used to treat Parkinson’s disease, certain pituitary tumors, and increasingly restless legs syndrome (RLS).
Examples include apomorphine (Apoquin), pramipexole (Mirapex), and ropinirole (Requip).
How they can cause memory loss: These drugs activate dopamine signaling pathways, a chemical messenger involved in many brain functions including motivation, the experience of pleasure, fine motor control, learning, and memory. This results in major adverse effects such as memory loss, confusion, delusions, hallucinations, drowsiness, overeating, and compulsive gambling behaviors.
Alternatives: If you are being treated for RLS, ask your doctor or pharmacist whether any of your prescription or over-the-counter medications may be triggers.