7, delirium, or memory problems, especially in older adults, and some drug exposures have been associated with increased dementia risk. That doesn’t mean Medications That Can Affect Memory and Cognition
The claim that certain medicines “cause severe dementia and profound brain damage” is too strong. Some medications can cause confusion, sedation, delirium, or memory problems, especially in older adults, and some drug exposures have been associated with increased dementia risk. That doesn’t mean they inevitably cause dementia or permanent brain damage.
1. Diphenhydramine
This first-generation antihistamine has strong anticholinergic effects and can cause drowsiness and confusion, particularly in older adults. It’s included in the American Geriatrics Society Beers Criteria as a medication generally best avoided by older adults when alternatives are available.
2. Amitriptyline
This tricyclic antidepressant also has substantial anticholinergic activity. It can contribute to confusion, sedation, dizziness, and cognitive difficulties, particularly in older people.
3. Oxybutynin
Oxybutynin is used to treat overactive bladder. Because it can significantly affect acetylcholine signaling in the brain, it may cause cognitive adverse effects, with older adults being particularly susceptible.
4. Benzodiazepines
Examples include diazepam, lorazepam, alprazolam, clonazepam, and temazepam.
They can cause sedation, impaired memory, confusion, and delirium and can increase fall risk, particularly in older adults.
If you’ve been taking a benzodiazepine regularly, don’t stop it suddenly. Withdrawal can be dangerous and should generally be managed gradually with medical supervision.
5. Z-Drugs
Sleep medicines such as zolpidem, zaleplon, and eszopiclone can cause next-day impairment, confusion, and memory problems. Older adults are particularly vulnerable to falls and other adverse effects.
6. Antipsychotic Medications
Drugs such as quetiapine, risperidone, olanzapine, and haloperidol can be essential treatments for some psychiatric conditions.
However, in older adults with dementia, antipsychotics are associated with increased risks of stroke and mortality and require careful consideration and monitoring.
7. Other Strong Anticholinergic Medicines
Several medication classes—including certain antihistamines, antidepressants, bladder medicines, and anti-nausea drugs—can have anticholinergic effects.
The concern can be greater when multiple anticholinergic medications are taken together, because their effects can accumulate.
Don’t Stop Prescribed Medicines on Your Own
A medication appearing on this list doesn’t mean it’s inappropriate for a particular person. Doctors may prescribe these medicines because their benefits outweigh their risks in an individual situation.
If you or an older family member develops new confusion, memory problems, excessive sleepiness, dizziness, or behavioral changes, ask a doctor or pharmacist to review all prescription medicines, over-the-counter products, and supplements.
Bottom Line
Some medications can adversely affect cognition, especially in older adults. But describing them as medications that inevitably cause “severe dementia and profound brain damage” overstates what the evidence shows.
A medication review can help determine whether a particular drug, dose, combination, or an underlying medical condition is contributing to cognitive symptoms.
