Alert: 8 Types of Medicines That Can Affect Memory and Thinking

The headline “8 drugs that cause serious dementia” is too strong. Some medicines can cause confusion, drowsiness, memory problems, or delirium, particularly in older adults, but that does not mean they cause permanent dementia. The risk depends on the medicine, dose, duration, and the person’s health.

Here are eight medication groups worth discussing with a doctor or pharmacist if memory or confusion has recently changed:

1. Anticholinergic medicines

These block acetylcholine, a chemical important for memory and brain function. Examples include some medicines for overactive bladder, allergies, motion sickness, and certain antidepressants.

Older adults can be particularly sensitive to their effects.

2. Benzodiazepines

Medicines such as diazepam, lorazepam, and alprazolam can cause sedation, impaired concentration, and short-term memory problems.

Long-term use in older adults is generally approached cautiously because of risks including falls and dependence.

3. First-generation antihistamines

Some older allergy medicines, such as diphenhydramine, have significant anticholinergic effects and can cause confusion or drowsiness.

They can be especially problematic for older people.

4. Certain sleep medicines

Some prescription and over-the-counter sleep medicines can impair alertness, attention, coordination, and memory, particularly when taken at higher doses or combined with other sedating medicines.

5. Opioid pain medicines

Medicines such as morphine, oxycodone, and codeine can cause drowsiness and confusion. In older adults, or at high doses, these effects can become pronounced.

Sudden confusion in someone taking an opioid needs medical attention because excessive sedation can accompany dangerous breathing problems.

6. Some antidepressants

Certain antidepressants have stronger anticholinergic or sedating effects than others. This doesn’t mean antidepressants generally cause dementia; rather, individual medicines can affect cognition differently.

Never stop an antidepressant suddenly without medical advice.

7. Some medicines used for bladder problems

Certain medications for urinary urgency and overactive bladder have anticholinergic effects. In susceptible older adults, they can contribute to confusion or memory difficulties.

There are also alternatives with different mechanisms, so a pharmacist or doctor can review the options.

8. Corticosteroids

Medicines such as prednisone can sometimes produce mood changes, insomnia, agitation, or confusion, particularly with higher doses. These effects aren’t the same as dementia and often improve when the underlying medication issue is addressed.

Does Medication Mean You Have Dementia?

No.

A medication can cause delirium or cognitive side effects that resemble dementia. Delirium often develops relatively quickly and may improve when the underlying cause—such as a medication, infection, dehydration, or metabolic problem—is treated.

Some research has also investigated whether prolonged exposure to certain anticholinergic medicines is associated with increased long-term dementia risk. An association, however, does not prove that the medication itself caused dementia, and the evidence varies among drug classes.

Don’t Stop Your Medicine Suddenly

If you or a family member has developed new memory problems, confusion, unusual sleepiness, or changes in behavior, ask a doctor or pharmacist to review every medication, including:

• Prescription medicines

• Over-the-counter medicines

• Sleeping tablets

• Allergy medicines

• Painkillers

• Herbal products and supplements

Don’t discontinue a prescribed medicine on your own, particularly benzodiazepines, antidepressants, corticosteroids, or opioids, because sudden withdrawal can itself be dangerous.

Important

Sudden confusion, difficulty speaking, weakness on one side, severe headache, loss of consciousness, or a major change in mental status can be an emergency. Seek urgent medical care rather than assuming it’s dementia or a medication side effect.