Do you take OTC Hay Fever Pills or Sleep Aids?

By Lee Bellinger / January 27, 2015

If you do, you may have to reduce your dose, or look to some other pharmaceutical solutions according to a recent study that suggests they increase the risk of Alzheimer’s.

According to a paper in JAMA Internal Medicine: “These findings have public health implications for the health of older adults about potential safety risks because some anticholinergics are available as over-the-counter products.”

Many medications have anticholinergic effects. According to the study, anticholinergic-induced cognitive impairment is considered reversible when you stop taking them. However, this and other studies have indicated that anticholinergics may be associated with an increased risk for dementia.

That suggests that taking a daily dose of pills like Benadryl, Piriton and Nytol, for at least three years, can increase the chance of getting Alzheimer’s disease. Other drugs on the risk-list include older antidepressants such as doxepin, and the bladder control treatment Ditropan.

The findings showed that people taking at least 10 milligrams per day of doxepin, four milligrams per day of diphenhydramine (Nytol, Benadryl) or five milligrams per day of oxybutynin (Ditropan) for more than three years would have an increased risk of developing dementia.

Available substitutes that did not have anticholinergic effects included selective serotonin re-uptake inhibitor (SSRI) antidepressants such as Prozac and newer anti-histamine allergy treatments including loratadine (Claritin.)

“If providers need to prescribe a medication with anticholinergic effects because it is the best therapy for their patient, they should use the lowest effective dose, monitor the therapy regularly to ensure it’s working, and stop the therapy if it’s ineffective,” added Professor Gray, the lead scientist on the study.

The study used data collected from the Adult Changes in Thought study in Group Health, an integrated healthcare delivery system in Seattle, Washington that studied 3434 participants aged 65 years or older with no dementia at the start of the study in 1994 through to 2012.

Using pharmacy dispensing data cumulative exposure to certain medications was updated as participants were followed up over time.

The most common anticholinergic classes used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics.

The official results showed that during a mean follow-up of 7.3 years, 797 participants (23.2%) developed dementia (637 of these [79.9%] developed Alzheimer’s disease). The study concluded that higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.


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