DISTURBING: Alzheimer’s Risk Linked To Advil PM, Dozens More Rx

More than 75 drugs commonly prescribed for COPD, overactive bladder, asthma, anxiety, dizziness and more  have now been linked to a 50 percent increase in Alzheimer’s risk.

How many have been taken off the market by Big Pharma or the FDA? Zero.

(CNN) Scientists have found a possible link between anticholinergic drugs [see list below] and an increased risk of dementia.

A study published in the journal JAMA Internal Medicine on Monday suggests that the link is strongest for certain classes of anticholinergic drugs — particularly antidepressants, bladder antimuscarinics, antipsychotics and antiepileptic drugs.

Researchers wrote in the study that “there was nearly a 50% increased odds of dementia” associated with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which is equivalent to an older adult taking a strong anticholinergic medication daily for at least three years, compared with no exposure.

“The study is important because it strengthens a growing body of evidence showing that strong anticholinergic drugs have long term associations with dementia risk,” said Carol Coupland, professor of medical statistics in primary care at the University of Nottingham in the United Kingdom and first author of the study.

“It also highlights which types of anticholinergic drugs have the strongest associations. This is important information for physicians to know when considering whether to prescribe these drugs,” she said, adding “this is an observational study so no firm conclusions can be drawn about whether these anticholinergic drugs cause dementia.”

She said that people taking these medications are advised not to stop them without consulting with their doctor first, as that could be harmful.

The study involved analyzing data on 284,343 adults in the United Kingdom, aged 55 and older, between 2004 and 2016.

The data came from QResearch, a large database of anonymized health records.

The researchers identified each adult’s anticholinergic exposure based on details of their prescriptions.

The researchers found the most frequently prescribed anticholinergic drugs were antidepressants, drugs to treat vertigo, motion sickness or vomiting and bladder antimuscarinic drugs, such as to treat overactive bladder. Read more. 

What are anticholinergic drugs? 

HealthLine – Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions. These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder.

List of anticholinergics

Anticholinergics are only available with a doctor’s prescription. Examples of these drugs include:

  • atropine (Atropen)
  • belladonna alkaloids
  • benztropine mesylate (Cogentin)
  • clidinium
  • cyclopentolate (Cyclogyl)
  • darifenacin (Enablex)
  • dicylomine
  • fesoterodine (Toviaz)
  • flavoxate (Urispas)
  • glycopyrrolate
  • homatropine hydrobromide
  • hyoscyamine (Levsinex)
  • ipratropium (Atrovent)
  • orphenadrine
  • oxybutynin (Ditropan XL)
  • propantheline (Pro-banthine)
  • scopolamine
  • methscopolamine
  • solifenacin (VESIcare)
  • tiotropium (Spiriva)
  • tolterodine (Detrol)
  • trihexyphenidyl
  • trospium

[In addition to these examples, see the full list below. – Ed.]

Uses

Anticholinergics are used to treat a variety of conditions. These include:

  • chronic obstructive pulmonary disease (COPD)
  • overactive bladder and incontinence
  • gastrointestinal disorders, such as diarrhea
  • asthma
  • dizziness and motion sickness
  • poisoning caused by toxins such as organophosphates or muscarine, which may be found in some insecticides and poisonous mushrooms
  • symptoms of Parkinson’s disease, such as abnormal involuntary muscle movement

Anticholinergics can also be used as muscle relaxants during surgery to assist with anesthesia. They help keep the heartbeat normal, relax the patient, and decrease saliva secretions.

Some doctors prescribe anticholinergics for off-label use to help decrease excessive sweating. The anticholinergics used most for this treatment are glycopyrrolate cream and oxybutynin oral tablets.

List of Anticholinergic Drugs to Be Avoided in the Elderly

Drugs.com – Note: Many of the below drugs are found in over-the-counter (OTC) products or in combination with other medications (prescription or OTC), so always check with your pharmacist if you are concerned about the use of anticholinergic drugs. This is not a complete list of anticholinergic medications, but includes many of the most common ones to avoid, when possible.

Antihistamines, First-Generation

* Use of diphenhydramine in acute allergic reactions may be appropriate; many OTC sleep agents have diphenhydramine as an active ingredient, be sure to check labels.

Antiparkinsonian Agents*

* In general, these agents are not recommended for prevention of extrapyramidal symptoms with antipsychotics. In addition, more-effective agents are available for treatment of Parkinson disease, especially for older individuals.

Skeletal Muscle Relaxants

Antiarrhythmics

Antidepressants

Antimuscarinics (Urinary Incontinence)

Antipsychotics*

*Boxed warnings exist about the use of antipsychotics in the elderly with dementia. Antipsychotics are not approved for use in psychotic conditions related to dementia. Antipsychotics may increase the risk of death in older adults with dementia-related conditions.

Antispasmodics

Antiemetics