Antidepressants and Bladder Medicines Linked to Dementia in Landmark Study

Common antidepressants can increase the risk of dementia by 30 per cent if they are taken for more than a year

Common antidepressants can increase the risk of dementia by 30 per cent if they are taken for more than a year

A study links the long-term use of some drugs with a higher risk of dementia.

As a general rule, they say, someone with a 10% of developing dementia in the next 15 years would see that increase to 13% if they had been on anticholinergics for a year or more - or a "one in 33 chance of getting dementia you would otherwise not have got".

The study also analyzed over 27 million prescriptions.

"Clinicians should continue to be vigilant with respect to the use of anticholinergic drugs, and should consider the risk of long-term cognitive effects, as well as short-term effects, associated with specific drug classes when performing their risk-benefit analysis".

The medications identified in this study are classified as anticholinergic, but researchers say several other anticholinergic medications were not found to be linked to dementia. This allowed the researchers to show that some types of anticholinergic medications were not associated with the onset of dementia.

Rob Howard, professor of old age psychiatry at University College London has a different opinion, arguing that "It is possible that use of some of these drugs may have actually been to treat the very earliest symptoms of Alzheimer's disease, which can be associated with low mood and lower urinary tract infections, many years before the development of dementia".

Anticholinergic drugs are used to treat a variety of conditions and work by blocking a key messenger (neurotransmitter) in the body called acetylcholine.

"Middle aged and older populations are increasingly taking multiple drugs, but the potential adverse events of long term use are not well understood", the researchers wrote.

The exact reasons for the increased risk of dementia among those taking certain anticholinergic medications remain unclear.

Not taking prescribed drugs could have serious consequences, Dr Maidment said.

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They said this does not prove that some anticholinergics cause dementia, but doctors should consider the long-term effects when prescribing them.

Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions such as overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression.

The study, led by a team at the University of East Anglia in the United Kingdom, involved a collaboration between teams in the United Kingdom, US and Ireland."These findings make it clear that clinicians need to carefully consider the anticholinergic burden of their patients and weigh other options", claims Malaz Boustani, M.D., MPH, a Regenstrief Institute and Indiana University (IU) Center for Aging Research investigator, and co-author of the researchers' published paper in the BMJ.

"Many of the treatment options for these conditions involve medication with anticholinergic effects".

Dr Ian Maidment, Senior Lecturer in Clinical Pharmacy at Aston University and lead pharmacist on the study, said: "We already have strong evidence that anticholinergics cause confusion and in the short-term will potentially worsen the symptoms of dementia".

"But patients, don't suddenly stop medications".

"But the headline claim that some drugs, especially antidepressants, can cause dementia up to 20 years later should be looked at closely".

What should patients do if they take any of these drugs?

"As a patient, if you are concerned about it, go and speak to your doctor or your pharmacist".

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