Alert: 8 Drug Groups That Can Affect Memory and Cognition
The phrase “drugs that cause serious dementia” is misleading. Some medications can cause confusion, delirium, sedation, or memory problems, and certain long-term medication exposures have been associated with increased dementia risk. But an association does not mean the medication inevitably causes dementia.
Eight groups worth discussing with a clinician—especially for adults over 65—include:
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Strong anticholinergic drugs — Some antihistamines, bladder medicines, and antidepressants can impair cognition.
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Benzodiazepines — Diazepam, lorazepam, alprazolam, and related drugs can cause sedation and memory impairment; prolonged use has been associated with dementia in observational studies.
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Z-drug sleeping medicines — Zolpidem and similar medicines can cause confusion and impaired alertness.
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First-generation antihistamines — Diphenhydramine and similar drugs have significant anticholinergic effects.
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Tricyclic antidepressants — Amitriptyline and related drugs can produce anticholinergic cognitive effects.
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Some bladder antimuscarinics — Oxybutynin and certain related medicines can affect cognition, particularly in susceptible older adults.
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Certain antipsychotics — These require particular caution in people who already have dementia because of increased risks of stroke and death, although they can be appropriate for specific conditions.
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Combinations of several sedating or anticholinergic medicines — The cumulative medication burden can substantially increase the risk of confusion and other adverse effects.
Don’t stop these medicines on your own
A drug being associated with cognitive problems doesn’t mean it’s inappropriate for everyone. Some provide important benefits, and abruptly stopping medications such as benzodiazepines can be dangerous.
If an older person develops new confusion, unusual sleepiness, hallucinations, or a noticeable change in memory, have a doctor or pharmacist review all prescription drugs, over-the-counter medicines, and supplements.
Sudden confusion is particularly important: it can be delirium caused by an infection, medication effect, stroke, or another acute medical problem and requires prompt assessment.
