By naturopath Margaret Jasinska

Two widely used types of drugs have been linked to a higher risk of dementia. The good news is safer alternatives usually exist.

You probably already know the basics of protecting your brain as you age: eat well, exercise, sleep enough, and stay mentally and socially engaged. You may not be aware that some medications used to manage anxiety, allergies, or sleep problems may work against that goal.

Two large population studies found that people who took benzodiazepines (a group that includes anti-anxiety medicines and sleeping pills) or anticholinergics (used for allergies, colds, depression, high blood pressure, and bladder problems) for more than a few months had a higher risk of developing dementia. In both studies, the risk rose along with the dose and how long the drug was used.

Benzodiazepines

These drugs calm anxiety and help with sleep by boosting a brain chemical called GABA.

Common examples: diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), temazepam (Restoril), flurazepam (Dalmane)

Anticholinergics

Block a brain chemical called acetylcholine, which is involved in learning and memory.

Common examples: certain antihistamines, tricyclic antidepressants, overactive-bladder medications, some sleep aids

What the research found

Neither study proved that these drugs cause dementia. Both were long-term observational studies, meaning researchers tracked large groups of people over time and looked for patterns, not controlled experiments. Still, the patterns were consistent and hard to ignore and other types of studies may not be ethical or possible.

Study 1: Anticholinergics

Researchers followed almost 3,500 adults age 65 and older for seven years, using pharmacy records to track every prescription and over-the-counter drug each person had taken over the prior decade. This was the first study of its kind to include nonprescription drugs, and the first to rule out the possibility that people were already taking these drugs to manage early, undiagnosed dementia symptoms.

800 of the 3,500 participants developed dementia during the study.

There was a 54% higher dementia risk for people who used anticholinergics for 3+ years, versus 3 months or less. People taking anticholinergic bladder medications had a risk increase just as high as those taking tricyclic antidepressants.

Study 2: Benzodiazepines

A team from France and Canada compared close to 2,000 people diagnosed with Alzheimer’s disease to more than 7,000 people of the same age and sex who did not have the disease, then looked back at their benzodiazepine prescriptions over the previous five to six years.

There was a 32% higher Alzheimer’s risk after 3 to 6 months of benzodiazepine use and 84% higher Alzheimer’s risk after more than 6 months of use.

Taking a benzodiazepine for three months or less didn’t appear to raise risk at all. The type of drug mattered too: long-acting versions like diazepam (Valium) and flurazepam (Dalmane) carried more risk than short-acting ones like triazolam (Halcion), lorazepam (Ativan), alprazolam (Xanax), or temazepam (Restoril).

Why older adults are more affected

As we age, the kidneys and liver clear medications more slowly, so drugs stay in the bloodstream longer. Body composition also shifts. We tend to gain fat and lose muscle which changes how drugs are absorbed and stored. Because these particular drugs are stored in body fat, they can keep affecting the brain for days after someone stops taking them. On top of that, older adults are often taking several medications at once, and each one can amplify or interfere with the others.

Anticholinergics block acetylcholine, a chemical the brain relies on for learning and memory. Benzodiazepines boost GABA, a chemical that calms nerve activity. Useful for anxiety and sleep, but tied to confusion and clouded thinking when used long term.

If you are taking one of these medications, please don’t discontinue it on your own. Have a consultation with your doctor and ask if there is a safer alternative.

Perimenopause and post menopause

Perimenopause and post menopause is a time where women often experience changes in mood and increased anxiety, irritability and insomnia may occur. Thankfully Bioidentical Hormone Replacement Therapy with progesterone, oestriol, oestradiol and sometimes a small dose of testosterone can make a large improvement in these emotional imbalances. For some women, the difference is dramatic improvement and obviates the need to use sedative drugs. In men mood disorders and anxiety can be the result of low testosterone and this can be treated successfully with bioidentical testosterone creams. Blood tests can be done to accurately measure your hormone levels. For more information call us on 0246554666 or email our wonderful team at Cabot Health.

Diet is also important and it is worth trying to increase the amount of protein and healthy natural fats in your diet. Neurotransmitters such as serotonin and dopamine are made from protein and your brain needs fat to be healthy.

If you would like to keep your brain healthy as you age, Dr Cabot’s book Alzheimer’s: What you must know to protect your brain will give you a lot of useful information.

Magnesium can help to make you feel calmer and can improve sleep quality.

Reference: https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain