What Medications Worsen the Symptoms of Dementia?
There are numerous medications that are linked to exacerbating the symptoms of Dementia.
These can include: Antidepressants, Antipsychotics, Anti-Parkinsonian drugs and Anticholinergics which have been shown to cause restlessness and other motor dysfunction due to their side effects.
Antidepressants
Although the function of antidepressants doesn’t directly correlate to dementia, it has been shown to interfere with it.
Antidepressants are similar to anticholinergics, as they operate in the brain; they obstruct the action of acetylcholine which leads to problems in the parasympathetic nervous system.
This then causes disturbances in cognition and functioning in the brain as the antidepressants and dementia symptoms would interfere with one another.
However, it is important to remember that it depends on the type of antidepressant also.
Three examples of common antidepressants that can inrease the symptoms of Dementia include tricyclic antidepressants (such as amitriptyline), SNRI’s and SSRI’s such as paroxetine (Seroxat).
Some antidepressants that are non-anticholinergic have actually been shown to increase cognitive function, which in turn does not increase the risk of dementia, yet anticholinergic antidepressants such as tricyclics do increase the risk of dementia.
Overall, it is ideal to de-prescribe where possible, and consider other treatment options for depression such as CBT (cognitive behavioural therapy). Talk to your GP about the best treatment option for you or your loved one.
Antipsychotics
Antipsychotics can be prescribed for dementia patients in order to ease agitation and prevent hallucinations or delusions. Sometimes antipsychotics are over prescribed to individuals who don’t really need it. This can be adverse for individuals living with dementia especially in the later stages as it could actually worsen the symptoms.
The different types of antipsychotics include typical such as chlorpromazine and atypical such as clozapine. For dementia patients, the antipsychotics usually prescribed are risperidone for short term usage and haloperidol.
The side effects of these antipsychotics can worsen dementia symptoms as it interferes with the cognitive functioning of the brain, leading to problems with memory and thinking.
As a solution, doctors should ensure antipsychotics are only prescribed as a last resort to avoid over-prescription and possibly use other non-drug methods of treatment for psychosis such as therapy.
Anti-Parkinsonian Drugs
Some people living with dementia could also be living with co-morbidities, for example, Parkinson’s disease which is where individuals have issues with motor control and refinement.
Often when an individual is taking a cocktail of medication for different conditions, they can worsen the symptoms of their other condition.
Anti-Parkinsonian drugs are mostly seen to effect dementia for Lewy bodies (DLB) and causes the removal of the protein alpha-synuclein from the nucleus of different brain cells.
The most common medication for treatment of Parkinson’s disease and dementia for Lewy bodies is Levodopa. Levodopa has been shown to cause psychosis and delirium as a side effect which in turn worsens the symptoms of an individual living with dementia.
As a result, some people resort to taking antipsychotics to ease the psychotic symptoms but it should be considered that antipsychotics could also worsen the symptoms of dementia, so taking more medications could lead to overall worsening of symptoms.
Consequently, treatments and drugs for individuals living with dementia should not be over-prescribed as most of these medications have negative side effects.
Consult with you GP for the best treatment plan for you or your loved one.
Anticholinergics
This group of drugs have been shown to worsen dementia symptoms due to the decrease of the neurotransmitter acetylcholine. This is an issue as the older we get, the less this neurotransmitter is produced regardless. However, anticholinergics make acetylcholine deplete even more.
Taking anticholinergics can cause side effects such as confusion, problems with memory, drowsiness and issues with reasoning, all of which cause dementia symptoms to worsen.
Anticholinergics range from antihistamine drugs to sleeping aid medication, which are all over the counter medications.
Consequently, individuals living with dementia or their primary caregiver and/or doctor should be made aware of what medications are anticholinergic and how they may affect the individual’s dementia.
Ultimately, it is important to understand which medications an individual living with dementia is currently taking in order to understand how these medications are affecting their symptoms of dementia.
Most of the time dementia symptoms worsen when the individual is taking a cocktail of medications which all cause the depletion of the neurotransmitter acetylcholine.
It is recommended to not over-prescribe individuals living with dementia where other treatment options may be equally as effective to avoid extra side effects worsening their condition.
Seek advice from a medical professional for a tailored treatment plan based on your needs.
