January 27, 2015

Tuesday, January 27, 2015
A new study reveals that higher doses or prolonged use of medications with anticholinergic effects significantly increases the risk for developing dementia.  Although, this is not the first study to discover such a link, it is the first to suggest that the risk of dementia as a result of taking such medications may not be reversible.
“An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. The nerve fibers of the parasympathetic system are responsible for the involuntary movement of smooth muscles present in the gastrointestinal tract, urinary tract, lungs, etc.”
Anticholinergic agents are used to treat a variety of conditions such as gastrointestinal disorders, respiratory disorders, insomnia, dizziness etc.  Some of these commonly used medications include Diphenhydramine (Benadryl, Advil PM etc.), Bupropion (Zyban, Wellbutrin), Dextromethorphan (cough suppressant) and the list goes on.  In addition, some of these medications can be acquired without a prescription and can have very strong anticholinergic effects.

Moreover, many older patients, already at higher risk of developing dementia, are frequently using these types of medications.  Doctors should be taking a proactive approach and monitoring the use of these drugs, including non-prescription use.
“For instance, the most commonly used medications in the study were tricyclic antidepressants like doxepin (Sinequan), first-generation antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan). The study estimated that people taking at least 10 mg/day of doxepin, 4 mg/day of chlorpheniramine, or 5 mg/day of oxybutynin for more than three years would be at greater risk for developing dementia.”
Consequently, the study suggests that medical professionals should seek substitutes such as citalopram (Celexa) or fluoxitene (Prozac) for depression or loratadine (Claritin) for allergies or behavioral changes for urinary incontinence.  However, if substitutes are not available, the suggestion is to prescribe the lowest dose possible, monitor its effectiveness closely and cease use if there is no real benefit to the patient.

This study differs from other research as it used more rigorous methods, longer follow-up periods and better assessment of medication use by using pharmacy records of both prescription and non-prescription use.  It is also the first of its kind to link anticholinergic medication dosages to dementia risk.  Results were obtained by tracking nearly 3,500 Group Health seniors participating in the long-running Adult Changes in Thought study (a longitudinal population-based prospective cohort study of brain aging and incident dementia in the Seattle metropolitan area), some of which have also agreed to have their brains autopsied after they die.  Stay tuned.

Quick Facts:

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life.

Alzheimer's is the most common type of dementia.

While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:

Memory
Communication and language
Ability to focus and pay attention
Reasoning and judgment
Visual perception

Many dementias are progressive, meaning symptoms start out slowly and gradually get worse.
Dementia is caused by damage to brain cells, which interferes with the ability of brain cells to communicate with each other.

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type.

Some risk factors for dementia, such as age and genetics, cannot be changed, however some of the most active areas of research in risk reduction and prevention include cardiovascular factors, physical fitness, and diet.

The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every four seconds. The number of people with dementia is expected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

The costs are estimated at US$ 604 billion per year at present and are set to increase even more quickly than the prevalence.

Caring for dementia patients is overwhelming for caregivers. The stresses include physical, emotional and economic pressures. Care givers require support from the health, social, financial and legal systems.

People with dementia are frequently denied the basic rights and freedoms available to others. For example, physical and chemical restraints are used extensively in aged-care facilities and acute-care settings.

Improving the awareness and understanding of dementia across all levels of society is needed to decrease discrimination and to improve the quality of life for people with dementia and their caregivers.

More research is needed to develop new and more effective treatments and to better understand the causes of dementia. Research that identifies the modifiable risk factors of dementia is still scarce.

Higher dementia risk linked to more use of common drugs
Anticholinergic
alz.org
World Health Organization

© www.mentalhealthblog.com

, , , , , , , , , , , , , , ,

No comments

0 comments:

Popular Posts

Dentalget.com is dental equipment supplier, we provide high quality dental instruments, dental handpiece at a discount price. Free shipping worldwide.

Categories

9/11 AADD Abortion Academic Success Acetylcholine ADD Adderall Addiction ADHD Adult Attention Deficit Disorder Adultery Advertising Aggression Aging Agreeableness AIDS Air Pressure Alcohol Alcohol Abuse Alcohol Dependence Alcoholism alpha-CaM kinase II Altitude Alzheimer's Amphetamine Amygdala Amyloid Amyloid Deposition Anesthesia Anger Anterior Cingulate Cortex Anterograde Amnesia Anti-Depressants Anti-Psychotic Anticholinergic Anticonvulsant Antiepileptic Antioxidants Anxiety Anxious-Avoidant Anxious-Preoccupied Apolipoprotein E Army Aromatherapy Asperger Syndrome Assessment Associative Learning Asthma Attachment Theory Attention Attention Deficit Disorder Attention Deficit Hyperactivity Disorder Autism Autism Spectrum Disorder Autonomic Nervous System Average Sleep Requirements B-type Natriuretic Peptide Babies Balance Behavioral Problems Behaviour Behavioural Impairment Behavioural Therapy Benadryl Bipolar Disorder Blood Clot Blood Pressure Blue Light Blue Light Goggles Body Mass Index Bone Marrow Brain Brain Development Brain Imaging Brain Injury Brain Stem Brain Surgery Breast Cancer Buddhism bullying Bupropion Business C-reactive Protein Calories CAMH Canada Canadian Charter of Rights and Freedoms Cancer Carbohydrates Cardiovascular Disease Care Facilities Caregiver cars Cdk5 Cell Phone Central Nervous System Centre for Addiction and Mental Health Cerebellum Cerebral Amyloid Angiopathy Cerebral Cortex Cerebrospinal Fluid Cerebrovascular Accident Cerebrovascular Insult Chat Rooms Chewing Childhood Disabilities Childhood Disintegrative Disorder Childhood Emotional Neglect Children Chitin Chitosan Cholesterol Choline Chromosome Chronic Pain Syndrome Chronic Stress Circadian Rhythm Cirrhosis Citalopram Classical Conditioning Climate Change Clot-Busting Drug Co-morbidity Cocaine Cognition Cognitive Development Cognitive Impairment Colloquially Brain Attack Coma Communication Device Communication Technology Concentration Concerta Concussion Conflict Confusion Conscientiousness Control Group Coordination Correlation Cortisol Counselling Couples CPAP Crack CRASH-2 CRASH-3 Creativity Criminal Code Cyberbullying Cyberpsychology Cyklokapron Daytrana Death Death Toll Decision-Making Declarative Memory Deep Brain Stimulation Delusion Dementia Dentures Depression Destrostat Deviant Behaviour Dexedrine Dextromethorphan Diabetes Diet Dietary Supplements Diphenhydramine Disability discrimination Dismissive-Avoidant Disorganized Attachment Disorganized Speech Disorientation Dizziness Docosahexaenoic Acid (DHA) Double-Blind Dream Drinking Drowsiness Drug Abuse Drug Dependence Drug Use Drugs DSM DSM-5 Dual Diagnosis Early Onset Alzheimer's Economic Crisis Ecstasy Effexor Ego Eicosapentaenoic Acid (EPA) Elderly Electrical Stimulation Electroconvulsive Therapy Electrodes Email Embitterment Embolic Emotion Emotional Neglect Emotional Problems Emotional Well-Being Employee Enrivonment Enzyme Epilepsy Estrogen Ethics Evolution Experimental Group Extracellular Signal-Regulated Kinase (ERK) Extroversion Facebook Facebook Fan Page Facebook Friends Family Family Therapy Fast Food Father Father Absenteeism Fatherhood FDA Fear Fearful-Avoidant FeelingBetterNow Fetus Fibrin Fish Oil fluoxetine fMRI Focalin Focus Food Fraud Friday Gamma Secretase Genetic Disorders Genetics Ginkgo Biloba Glucose Glutamate Receptor God Gout Guest Blogger Hair Pulling Haiti Hallucination Hallucinogenic Halo Effect Harm-Reduction Headache Healthy Eating Hearing Heart Attack Heart Disease Hematopoietic Stem Cells Hepatitis Hepatitis C Herbal Supplements Hereditary Angioedema Heredity Heroin High Blood Pressure Hippocampus Hockey Homelessness Hormone Housing Hox Genes Hoxb8 Cells Human Rights Hydromorphone Hyper-social Networker Hyperactivity Hypothalamus Illness Impulse Control Impulsivity Inattentiveness Infant Infidelity Inflammation Insecure Attachment Insomnia Instant Messaging Insulin Intellectual Development Intellectual Disability Internet Intracranial Bleeding Introversion Introvert Ischemic Stroke KASPAR Ketamine Ketogenic Kleptomania Laptop Latent Inhibition Learning Learning Disability Leukotrienes Limbic System Lithium Liver Locked-In Syndrome Long Term Memory Long-Term Potentiation Longevity Lupus Lysteda Maestro Rechargeable System Major Depression Mania MAOI Marriage MDMA Medication Meditation Melatonin Memory Memory Loss Memory Task Men Mental Health Mental Health Forum Mental Heath Mental Illness Metadate Metyrapone Mice Microglia Mild Cognitive Impairment (MCI) Mild Traumatic Brain Injury Military Mind-Body Mindless Eating Mitochondria MOHLTC Mood Disorder Morphine Mortality Rates MRI MS-275 Multiple Sclerosis Muscle Weakness music therapy Narcissism Natasha Richardson National Sleep Foundation Natural Disaster Nature/Nurture Nausea Necrosis Neglect Nerve Neuro-imaging Neurobiology Neurodegeneration Neurodegenrative Diseases Neurodevelopment Disorders Neurogenesis Neurological Disease Neuromarketing Neuron Neuropathy Neuroticism Neurotransmitter News Nintendo Wii Non-REM Sleep Nose Nurse Ratched Nutrition Obesity Obessive Compulsive Spectrum Disorder (OCD) Offspring Olfactory Gland OM3 Emotional Balance Omega 3 Ontario Ontario Review Board Ontario Works Opioid Oral Health Organic Ottawa Over-activity Over-Medication Ovulation Oxidative Cell Oxygen Oxytocin p35 Pacemaker Pain Pain Killer Pain Management Pancreatic Polypeptide Pancreatitis Paralysis Paranoia Paraskevidekatriaphobia Parenthood Parents Parkinson's Paroxetine Paxil PDD-NOS perception Perfume Peripheral Nervous System Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) Pathway personality traits Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) PET Scan Pharmacology Phobias Physical Health Physiological Plasmin Plasminogen Plasticity Platelet-Activating Factor Politics Post-Concussion Assessment and Cognitive Test (ImPACT) Potassium Ion Channel Poverty Pregnancy Pressure Procedural Memory Promiscuity Prozac PsychBoard.com Psychiatric Ward Psychological Psychological Inventories Psychologist Psychology Psychology Forum Psychology of Eating Psychosis PTED PTSD Public Health Pyromania Quadriplegic Rehab Relationships Reliability Religion REM Research Retigabine Retrograde Amnesia Rett Syndrome Risperdal Ritalin road rage Robot Robotics Rodent Research Rosiglitazone Samsung Satiety Scales Schizophrenia School Screening Secure Attachment Sedatives Seizure Self-Affirmation Intervention Self-Confidence Self-Esteem Self-Integrity Self-Worth Semantic Memory Senior Seroquel Serotonin Serzone Sex Sex Therapy Sexual Orientation Sexual Satisfaction Shock Therapy Sideline Concussion Assessment Test (SCAT2) Sleep Sleep Apnea Sleep Disorders Sleep Quality Sleep Stages Smartphone Smoking Snacking Sniffing Technology Social Assistance Social Deficits Social Isolation Social Media Social Network Social Rejection Social Skills Social Worker Socialization Societal Change Soft Palate Soldier Somatic Nervous System Spatial Memory Special K Speech Spinal Cord Spinal Cord Injury Spinal Tap Sports Injury SSRI Statin Stem Cell Stimulant Strattera Stress Stress Hormone Stroke Substance Abuse Sugar Suicide Superstition Support Survey Suspicious Tablet Talk Therapy Tamoxifen Tanorexia Tax Payer Technology Television Telomere Temperature Testosterone Texting Therapy Thorazine Threshold Thrombosis Thrombotic Tinnitus Tissue Plasminogen Activator Topographical Disorientation Tranexamic Acid Trauma Treatment Tremors Trial Tribunal Trichotillomania Type-2 Diabetes Vagus Nerve Validity Ventromedial Prefrontal Cortex Video Games Virtual Reality Vision Visual Attention Vitamin B Vitamins Vitiligo Voice Vyvanse Walnuts Weight Loss Welfare Wellbutrin Wernicke–Korsakoff syndrome Wet Brain White Blood Cells Women Work World Health Organization Zileuton Zyban Zyprexa µ-opiate receptors (MOR)