Older adults can be especially sensitive to these effects. Long-term use has also been associated with cognitive concerns, although the relationship between benzodiazepines and dementia remains uncertain.
What to do: If you take one of these medications regularly and notice memory problems, discuss your treatment with your prescriber. Do not stop suddenly, because abrupt withdrawal can cause serious complications, including seizures.
3. Certain Sleep Medications
Prescription sleep medicines may help people who struggle with insomnia, but some can affect alertness, memory, coordination, and balance.
Examples include zolpidem, zaleplon, and eszopiclone.
Possible effects include:
- Drowsiness the following day.
- Difficulty remembering events.
- Confusion.
- An increased risk of falls, particularly in older adults.
These effects do not mean that everyone who uses a sleep medication will develop dementia. The risks depend on the particular medicine, dose, duration of use, and other health factors.
What to do: Ask your healthcare professional to review persistent sleep problems and whether your medication remains necessary. Behavioral treatments for insomnia, including cognitive behavioral therapy for insomnia (CBT-I), may be appropriate for many people.
4. Certain Bladder Control Medications
Some medications used to treat an overactive bladder work by blocking acetylcholine receptors. While they can reduce urinary urgency and frequency, their anticholinergic effects may also affect thinking and memory.
One example is oxybutynin.
Potential side effects include dry mouth, constipation, blurred vision, and confusion. Older adults may be more susceptible to these effects.
Some observational studies have associated cumulative exposure to certain anticholinergic medications with increased dementia risk, but the degree of risk varies, and causation has not been established.
What to do: If you take medication for bladder symptoms and have noticed cognitive changes, ask your clinician whether another treatment may be suitable. Do not discontinue prescribed treatment without guidance.
5. Certain Antidepressants With Anticholinergic Effects
Antidepressants are a diverse group of medications, and their effects on cognition vary considerably.
Some older antidepressants, including amitriptyline, have strong anticholinergic effects. These can contribute to sleepiness, confusion, and difficulty concentrating, especially in older adults.
However, it would be inaccurate to say that all antidepressants damage the brain or cause dementia. Depression itself can also affect concentration, memory, sleep, and motivation.
What to do: If you experience new memory difficulties after starting an antidepressant or changing your dose, discuss the symptoms with your prescriber. The appropriate treatment depends on your diagnosis, response to medication, and overall health.
Never stop an antidepressant abruptly without medical advice.
