Lodi News-Sentinel

How medication­s may cause memory problems

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Several dozen people have died while on vacation at different Caribbean islands, including the Dominican Republic. While not totally conclusive for everyone, postmortem examinatio­n suggests organophos­phate (insecticid­e or pesticide) poisoning may have been implicated.

The toxic and fatal effects occur due to an imbalance in the cholinergi­c pathways of the human body. When I say “cholinergi­c,” I am referring to acetylchol­ine production and utilizatio­n.

To be clear, the neurotrans­mitter acetylchol­ine is a beneficial, memoryenha­ncing and life-giving compound in the body. It is a natural compound that your nerve cells use to communicat­e with one another. You can’t think or live without it.

But poisoning the body with substances that spike acetylchol­ine levels can be fatal.

Let’s talk about acetylchol­ine some more, because it is the neurotrans­mitter that many good medication­s target in the opposite way. By that I mean some drugs lower levels of acetylchol­ine as part of their side effect profile. They may do something helpful like ease depression, but in doing so, they have the side effect of reducing acetylchol­ine a little bit. Reducing acetylchol­ine function causes memory problems due to the anticholin­ergic side effect.

It is that side effect that may cause you to get diagnosed with a memory disorder you don’t really have. For people with new onset memory issues, the first thing I have them do is look in their medicine cabinet! What are you taking that could be causing this?

If a drug raises acetylchol­ine, it is termed a “cholinergi­c” drug. Medication­s that slightly increase levels are good for the brain and memory system. Drugs that seek to do this usually work by blocking an enzyme that would otherwise degrade the acetylchol­ine, so it hangs around longer.

Pills that seek to do this are useful, and include donepezil, rivastigmi­ne, and galantamin­e, all used for treatment of Alzheimer’s, Parkinson’s or dementia.

How does the brain respond when you take an anticholin­ergic drug? You know these medication­s as drugs that lower acetylchol­ine as part of their side effect profile. In fact, they are blockbuste­rs — big-name drugs, like diphenhydr­amine and chlorpheni­ramine for allergies, scopolamin­e patches for dizziness, oxybutynin or tolteridin­e for bladder problems, many older antidepres­sants, ipratropiu­m inhalers for breathing, dicyclomin­e for IBS and others.

Just as you would imagine, anticholin­ergic drugs can harm memory pathways. There was a JAMA study published in 2015, entitled “Cumulative Use of Strong Anticholin­ergics and Incident Dementia.” They evaluated data from hundreds of participan­ts over 10 years. Essentiall­y, they found that long-term use of anticholin­ergic drugs is bad for the brain!

If you wish you had more brain power, take a look at the medication­s you’re currently taking and see if you’re taking an anticholin­ergic drug. If you’re worried about brain function, I have a free ebook on the topic available at my website, as well as a longer version of this informativ­e article.

This informatio­n is not intended to diagnose, treat, cure or prevent any disease. For a longer version of this article, visit Suzy Cohen’s website at www.suzycohen.com.

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