Do some of the medications you use affect the brain? (Let's learn about Anticholinergic Medications)

If you open your medicine cabinet at home, you'll probably find one of these types of drugs. We're talking about some of the drugs used for allergies, depression, chronic pain, nausea, or insomnia. These are drugs that we've been using for decades. But new research shows that long-term use of these drugs may not be so good for our brain health. It may even increase the risk of developing dementia , a disease of memory loss. So let's take a look at what these anticholinergic drugs are, how they affect the brain, and how to manage them safely.

What exactly are these anticholinergic medications?

Simply put, these medications can be divided into two main categories. The first category is those that we use intentionally to achieve an anti-cholinergic effect. The second category is those that are given for another primary purpose, but have a strong anti-cholinergic effect as a side effect. The table below shows some of the common uses of these medications.

How do these medications affect our brain?

It's very simple. When these anti-cholinergic drugs enter the brain, they block a chemical called acetylcholine . This acetylcholine is a neurotransmitter that is essential for the functioning of a large number of neurons in the brain. Think of your brain as a big post office. Acetylcholine is a very important messenger in it. It is what helps store memories, keep information in short-term memory, and organize it into long-term memories. So what these drugs do is interfere with the work of that messenger. If they don't stop it completely, they significantly reduce the activity of those neurons.

What effects can using these have on brain function?

Research shows that these medications are not very good for your memory and thinking skills. In particular, the longer you use them, the harder it is to reverse the effects. Let's break this risk down into three time periods. 1. Immediate effect: Even if you take this medication once, you may experience memory problems. We don't think that taking it once will cause permanent damage. But even short-term use can cause memory problems. 2. Short-term long-term effect: Imagine that you have been taking this medication for several months . In that case, after stopping the medication, it may take several months for the effects on memory to completely disappear. Usually, in clinics, a patient's memory and thinking skills are re-evaluated at least three months after stopping such a medication. 3. Long-term effects: Evidence accumulated over decades suggests a link between these anti-cholinergic drugs and dementia , especially Alzheimer's disease .

Who is most at risk for these effects?

Two main factors affect this.

• Aging : As we age, we become more sensitive to the side effects of any medication. Unlike when we were younger, our bodies take longer to recover as we age. Therefore, we need to be more careful with our medications. This is especially true for anti-cholinergic medications.

• Genetic predisposition : Some people are genetically predisposed to Alzheimer's disease. This is due to a gene variant called ApoE4 . Research has found that people with this gene are at increased risk of memory loss when they take anti-cholinergic medications.

One study found that people over the age of 55 who used the equivalent of taking a strong anti-cholinergic drug at the minimum recommended daily dose for 3 years over a 10-year period had a 50% increased risk of developing dementia.

So what should people who use this medicine do?

The most important thing is to never stop taking any medication that your doctor has prescribed. Doing so can make your condition worse. Imagine you suddenly have a severe allergic reaction and need to take a medication at that time. Taking it once is not a big deal. The problem is using it frequently and for a long time. What you should do is talk openly with your doctor about the medications you are taking. "Doctor, does this medication I am taking have anti-cholinergic effects? Should I continue taking it? Are there any other options for me?" Ask yourself. Overall, if you are concerned about your brain health, it is best to stay away from medications that have anti-cholinergic effects as much as possible.

What other alternatives can be used instead of this medicine?

Fortunately, today we have safer alternatives for many of these conditions.

Insomnia problems

The best way to do this is to establish good sleep habits. Go to bed at the same time every day. Stop looking at your phone or TV before bed. If you can't fall asleep within 15 minutes of going to bed, get up and do something else in a dark place without your phone for 15 minutes before going back to bed. If necessary, talk to your doctor about using something like melatonin .

Anxiety and Depression

There are many other medications that do not have anti-cholinergic effects for these conditions. For example, medications like Duloxetine can be used for both depression and pain. Counseling is also a very powerful tool.

Difficulty controlling urination

There are now new-generation medications for this as well that do not have the anti-cholinergic risks. Mirabegron is one such medication.

Long-term pain

Physical therapy should be the mainstay of treatment for most chronic pain conditions. There is evidence that physical therapy can reduce pain more effectively than medication.

Allergies

There are many new classes of antihistamines available in pharmacies. Examples include Cetirizine , Fexofenadine , and Levocetirizine . However, be careful if you buy some cough and cold medications from the pharmacy with the suffix "DM" on the end of the name. They often contain diphenhydramine . Anticholinergic, medication, brain health, dementia, memory loss, forgetfulness, side effects, side effects, Alzheimer's