What Causes Alzheimer's Disease - Drug Use

Posted on

Jul 28, 2024

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Hi, this is Teri.  I am a 3rd generation Alzheimer’s Survivor and a co-caregiver of a parent who is surviving and thriving despite having Alzheimer’s Disease.

 

This week we will talk about medications that can create and cause memory loss. Over an extended period, memory loss might develop into Alzheimer’s Disease.

 

To be clear, I AM NOT A MEDICAL DOCTOR. While I worked in a pharmacy for the last 4+ years with two of the most amazing mentors, I am not a Doctor of Pharmacy either. I am not a nurse. I am not a medical assistant. I am an individual who can take complex information and recompose it so nonmedical individuals can understand it enough to know if this affects them or their loved ones.  With this knowledge, they can schedule an appointment and talk to their doctor.  Also, I can make suggestions for some supplemental nutritional solutions to help.

 

Most of us know some of the things that can impair memory, including alcohol and drug abuse, heavy cigarette smoking, head injuries, stroke, sleep deprivation, severe stress, vitamin B12 deficiency, and depression.  Over the last few years, we have added illnesses like Covid-19 to that list.

 

What many people don’t realize is that a number of commonly prescribed drugs and over the counter (OTC) medications also can interfere with memory. The medications I am most concerned about are those with anticholinergic properties. This means that the medications block the effect of acetylcholine.  Acetylcholine is an important brain chemical and neurotransmitter that becomes less plentiful in the aging brain (those of us over 40). These medications have an impact on brain cells by occupying that cell’s receptor molecules and can help people gain relief from symptoms of insomnia, irritable bowel syndrome, or several other medical conditions.

The consequences of anticholinergic medication usage can be serious.  Side effects include dry mouth, dry eyes, constipation, or urinary retention may occur. The toxic effects of anticholinergic medications on the brain include confusion, memory disturbance, agitation, and even dementia. The classifications of the medications are:

 

Antianxiety drugs (benzodiazepines)

Benzodiazepines are used to treat a variety of anxiety disorders, agitation, and seizures. Because benzodiazepines have a sedative effect, they are often used to treat insomnia and the anxiety that can accompany depression.

Examples: Alprazolam (Xanax), chlordiazepoxide, clonazepam (Klonopin), diazepam (Valium), flurazepam, lorazepam (Ativan), midazolam, quazepam (Doral), temazepam (Restoril) and triazolam (Halcion).

How they can affect memory: Benzodiazepines reduce activity in key parts of the brain, including those involved in the transfer of information and experiences from short-term to long-term memory. They’re used in anesthesia for this very reason.

Alternatives: Benzodiazepines should be prescribed only rarely in older adults, and then only for short periods. It takes older people much longer than younger people to flush these drugs out of their bodies, and the ensuing buildup puts older adults at higher risk for not just memory loss but delirium, falls, fractures, and motor vehicle accidents. Benzodiazepines are easily very addictive and almost impossible to stop.

If you or your loved one take any of these medications, and you are concerned about memory loss, you must weigh the benefits vs the risks.  It is common to see Benzodiazepines used to treat Alzheimer’s patients who are sundowning. This is an instance where quality of life needs to be considered.   

NEVER STOP TAKING THESE MEDICATIONS COLD TURKEY!  You MUST consult your health care professional before stopping or reducing the dosage of any benzodiazepine. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

 

Antiseizure drugs

Antiseizure drugs or anticonvulsants are used to treat epilepsy and symptomatic seizures. A neurologist will select the medication based on the type of seizure, side effects, drug interactions, and other health conditions. These medications can also be prescribed for nerve pain, pain after surgery, bipolar disorder, mood disorders, and mania.

Examples: Carbamazepine (Tegretol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), pregabalin (Lyrica), rufinamide (Banzel), topiramate (Topamax), valproic acid (Depakote), phenobarbital (Luminal), primidone (Mysoline) and zonisamide (Zonegran).

How they can affect memory: Anticonvulsants are believed to limit seizures by dampening the flow of signals within the central nervous system (CNS). Drugs that depress signaling in the CNS can cause memory loss. One thing to note: These medications can be sedating, making it hard to separate what is a true cognitive decline from simple sedation.

Alternatives: Many patients with seizures do well on phenytoin (Dilantin), which, at lower doses, has less of an impact on memory. Patients with chronic nerve pain find that venlafaxine (Effexor) – which also spares memory – alleviates their pain.

NEVER STOP TAKING THESE MEDICATIONS COLD TURKEY!  You MUST consult your health care professional before stopping or reducing the dosage of any antiseizure medication. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

 

Tricyclic antidepressants

This is an older class of antidepressant drugs and is prescribed less often these days, but some people still use tricyclics for depression, anxiety disorders, obsessive-compulsive disorder, and nerve-related pain.

Examples: Amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil).

How they can affect memory: Tricyclic antidepressants block the action of serotonin, norepinephrine, and other chemical messengers in the brain, which can lead to several side effects, including memory lapses.

Alternatives: Newer antidepressants like fluoxetine (Prozac), sertraline (Zoloft), and other selective serotonin reuptake inhibitors (SSRIs) don’t have the same anticholinergic effects as tricyclic antidepressants and therefore don’t interfere with cognition.

NEVER STOP TAKING THESE MEDICATIONS COLD TURKEY!  You MUST consult your health care professional before stopping or reducing the dosage of any antidepressant. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

 

Narcotic painkillers (opioids)

Narcotics are used to relieve moderate to severe pain from surgery or injuries. In some instances, they can also be used to treat chronic pain. Narcotics are easily addictive and almost impossible to stop.

Examples: Fentanyl (available as a patch), hydrocodone (Vicodin), hydromorphone (Dilaudid, Exalgo), morphine, and oxycodone (Oxycontin). These drugs come in many different forms, including tablets, solutions for injection, transdermal patches, and suppositories.

How they can affect memory: These drugs work by stemming the flow of pain signals within the central nervous system and by blunting one’s emotional reaction to pain. Both these actions are mediated by chemical messengers that are also involved in many aspects of cognition, so the use of these drugs can interfere with long- and short-term memory, especially when used for extended periods. Researchers have also found a link between opioid use and dementia in older adults.

Alternatives: In patients under the age of 50 years, nonsteroidal anti-inflammatory drugs (NSAIDs) are the frontline therapy for pain. Unfortunately, NSAID therapy is less appropriate for older patients, who have a much higher risk of gastrointestinal bleeding.

Acetaminophen (Tylenol) may be another option, but again, it’s important to consult your doctor about risks, side effects, and drug interactions for all medications.

NEVER STOP TAKING THESE MEDICATIONS COLD TURKEY!  You MUST consult your health care professional before stopping or reducing the dosage of any narcotics. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

 

Sleeping aids (nonbenzodiazepine sedative-hypnotics)

Sleeping aids are used to treat insomnia and other sleep problems. They are also prescribed for mild nighttime anxiety and sundowning. Sleeping aids are highly addictive!

Examples: Eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).

How they can affect memory: Although these are molecularly distinct from benzodiazepines, they act on many of the same brain pathways and chemical messengers, producing similar side effects and problems with addiction and withdrawal. These sleeping aids also can cause amnesia and sometimes trigger dangerous or strange behaviors, such as cooking a meal or driving a car with no recollection of the event upon awakening.

Alternatives: There are alternative drug and nondrug treatments for insomnia and anxiety, so talk with your healthcare professional about options. Melatonin, for instance, can help to reestablish healthy sleep patterns. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for the sleep disorder.

NEVER STOP TAKING THESE MEDICATIONS COLD TURKEY!  You MUST consult your health care professional before stopping or reducing the dosage of any sleeping aid medication. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

 

Incontinence drugs (Anticholinergics)

Incontinence medications are used to relieve symptoms of overactive bladder and reduce episodes of urge incontinence, an urge to urinate so sudden and strong that you often can’t get to a bathroom in time.

Examples: Darifenacin (Enablex), oxybutynin (Ditropan XL), solifenacin (Vesicare), tolterodine (Detrol), and trospium (Sanctura). Another oxybutynin product, Oxytrol for Women, is sold over the counter.

How they can affect memory: Patients who take anticholinergics can have complications with their long-term memory. These medications have been associated with an increased risk of dementia, and that heightened risk can persist even after the medication has been discontinued.

Older adults are particularly vulnerable to the other adverse effects of anticholinergic drugs, including constipation (which, in turn, can cause urinary incontinence), blurred vision, dizziness, anxiety, depression, and hallucinations.

Alternatives: As a first step, it’s important to make sure that you have been properly diagnosed. Check with your doctor or another health professional to see if your urinary incontinence symptoms might stem from another condition (such as a bladder infection or another form of incontinence) or a medication (such as a blood pressure drug, diuretic, or muscle relaxant).

Once these are ruled out, try some simple lifestyle changes, such as cutting back on caffeinated and alcoholic beverages, drinking less before bedtime, and doing exercises to strengthen the pelvic muscles that help control urination.

Some urologists are treating overactive bladder with Botox injections to help the muscle relax. Solutions beyond the medicine aisle can also come in handy. There have been huge improvements in protective undergarment items. Please do not call them diapers!  Party pants sound a lot more fun.

 

Antihistamines (first generation)

Antihistamines are used to relieve or prevent allergy symptoms or symptoms of the common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting, and dizziness, and to treat anxiety or insomnia.

Examples: Brompheniramine (Dimetane), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl), promethazine (Phenergan) and hydroxyzine (Vistaril).

How they can affect memory: These medications are prescription and available over-the-counter.  They inhibit the action of acetylcholine, a chemical messenger that mediates a wide range of functions in the body. In the brain, they inhibit activity in the memory and learning centers.

Alternatives: Newer-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are better tolerated by older patients and do not present the same risks to memory and cognition. My favorite solution to replace an antihistamine is a product from OrthoMolecular called D-Hist (adults) and D-Hist Jr. (kids).  It is just as effective as any antihistamine I have ever used, but it is natural without negative side effects.  For more information on D-Hist – click here:  https://amzn.to/3A9SWeQ .

 

One of the best lessons I learned in my years working at an independent pharmacy was not to judge anyone for their use of any medication. Not only was it none of my business, but I don’t know anything about what our patients have lived through.

There were always patients who lied about why they needed their pain medications, Adderall or Ambien early.  Some of those patients had a new excuse every month for the 4 years that I was there. But as I got to know all of our patients better, I understood that everyone self-medicates or self-soothes themselves in one way or another. 

Some take a pill to go to sleep so they stop thinking about the trauma, abuse, and/or neglect they experienced when they were younger.  Often the pill they take to escape those thoughts at night requires them to take a pill in the morning to get up and go.  But when they can get up and go, they spend their time serving others.  So don’t judge.

Other people cut themselves, binge eat, drink until they pass out, abuse their family members, shop, abuse street drugs, become sexually inappropriate (whatever you define as inappropriate), rage, fight, or scroll videos on their phones to self-soothe themselves to a point where they can relax, find peace and sleep. 

 

As you review your and your loved one’s prescription, OTC or recreational drug keep this in mind.  There was a trigger that started the drug use

If your 85-year-old Dad needs an Ativan every afternoon at 3pm so he can find some peace and not rage as he is experiencing Alzheimer-related sundowning, OK.

If at 32 you want an Ativan to go with a glass of wine. Talk to your doctor.  You might benefit from therapy to address an issue from your past and a low-dose CBD/THC gummy to relax.  Every situation is different and a loving and kind decision can be made without judgment.

 

If you are interested in supplementing your body & brain to optimize brain health, this is what I suggest:

All Adults over 40 should take the following:


MultiVitamin

EPA/DHA Fish Oil

Vitamin D3 +K2

Methylated B Vitamins

Tumeric/Curcumin

Berberine

Choline


 

 

Multi Vitamin Options

Metagenics PhytoMulti

https://amzn.to/3Sp2KrC

Global Healing

https://amzn.to/3WqtLw4

Pure Encapsulations

https://amzn.to/3LFjsiO

 

Brain Health Options

Metagenics Magnesium L-Threonate

https://amzn.to/3LMThXm

Pure Encapsulations Cogni-Mag (Magnesium Threonate)

https://amzn.to/3LOFJut

Pure Encapsulations Choline

https://amzn.to/4c2ah6M

Pure Encapsulations Brain Reset (Lion’s Mane)

https://amzn.to/4c1F03Y

 

EPA/DHA Fish Oil

Metagenics OmegaGenics EPA/DHA 100

https://amzn.to/4c2SMU1

Pure Encapsulation EPA/DHA

https://amzn.to/3A1EA0e

 

Vitamin D3 +K2

Metagenics D3 +K2

https://amzn.to/3LHukN7

Pure Encapsulations D3 +K2

https://amzn.to/3yh9np8

 

Methylated B Vitamins

Metagenics Glycogenics B Complex

https://amzn.to/3SvB2cT

Pure Encapsulations - B Complex Plus

https://amzn.to/4doqxAh

Gaia Pro B Complex

https://amzn.to/3SqCgX1

 

Tumeric/Curcumin

Metagenics Inflavanoid Intensive Care

https://amzn.to/4bYMuV

Pure Encapsulations Curcumin 500

https://amzn.to/3yjmAOm

 

Berberine

Metagenics Berberine GT

https://amzn.to/3LI5flm

Pure Encapsulations Berberine UltraSorb

https://amzn.to/4doqxAh

Gaia Pro Berberine

https://amzn.to/4dlbQ0J

 

Choline

Pure Encapsulations Choline

https://amzn.to/4c2ah6M

Standard Process Choline

https://amzn.to/3WogFj9

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Essential Tips for Caring for Aging Parents:

Essential Tips for Caring for Aging Parents: A Guide for Family Caregivers Caring for aging parents is a journey filled with both challenges and rewards. As our loved ones age, their needs often become more complex, requiring dedicated support and thoughtful planning. Whether youre just starting this caregiving journey or have been navigating it for years, having the right tools and knowledge can make all the difference. Below is essential caring for aging parents tips, practical advice, and insights into family caregiver support that will guide you in providing the best care for your elderly loved ones.Understanding Your Parents NeedsOne of the first steps in caring for aging parents is understanding their specific needs. Everyone will require a unique approach based on their health, mobility, cognitive abilities, and emotional state. Health Assessments: Regular health assessments are crucial. Ensure that your parents are visiting their doctor routinely and that their medications are regularly reviewed. Physical Needs: Evaluate their physical abilities. Are they able to perform daily tasks such as bathing, dressing, or eating independently? Recognizing areas where they need assistance helps ensure their safety and well-being. Mental Health: Aging can sometimes lead to depression, anxiety, or cognitive decline. Being aware of their mental and emotional health allows for early intervention and appropriate care. Organizing Finances and Legal AffairsElderly care often requires navigating financial and legal matters. Helping your aging parents organize their finances and legal affairs is an important aspect of being a family caregiver. Financial Planning: Begin by discussing your parents financial situation. Ensure they have the means to cover medical expenses, long-term care, or other related costs. You might consider speaking with a financial advisor to plan for future needs. Legal Documents: Ensure essential legal documents such as wills, power of attorney, and healthcare directives are in place. These documents help make critical decisions easier during emergencies. Creating a Safe Living EnvironmentAging parents often experience changes in mobility and balance, increasing the risk of falls or accidents. Adapting their living environment to suit their current needs is a key part of elderly care. Home Modifications: Simple modifications like installing grab bars in bathrooms, removing tripping hazards, and improving lighting can make a significant difference in creating a safer environment for your aging parents. Assistive Devices: Consider using assistive devices such as walkers, canes, or stairlifts to help maintain your parents mobility and independence. Building a Support NetworkAs a family caregiver, you dont have to handle everything on your own. Building a strong support network is essential for both your well-being and the well-being of your aging parents. Family Involvement: Involve other family members in caregiving. Whether its dividing tasks or providing emotional support, having a team approach reduces stress and ensures your loved one is cared for properly. Professional Support: Sometimes, the level of care required exceeds what family members can provide. In such cases, consider hiring professional caregivers, whether for full-time care or respite care, to give you a much-needed break. Maintaining Open CommunicationEffective communication between family caregivers and their aging parents is critical in ensuring that their needs are met and their preferences are honored. Regular Conversations: Engage in regular conversations with your parents about their care, preferences, and concerns. Keep communication open, honest, and respectful. Respecting Their Wishes: Even though youre making decisions in their best interest, its important to respect their wishes whenever possible. Whether its about living arrangements, medical treatments, or personal care, their input should be considered. Prioritizing Your Own Well-BeingCaring for aging parents can be emotionally and physically taxing. Its easy to focus entirely on their needs, but neglecting your own health and well-being can lead to caregiver burnout. Self-Care: Take time to care for your own physical and mental health. Regular exercise, proper sleep, and relaxation techniques can help you recharge and be more effective in your caregiving role. Support Groups: Family caregivers can benefit from joining support groups where they can share experiences, advice, and encouragement. Many local communities and online forums offer these groups, providing a place for caregivers to connect. Managing Medical and Personal CareMany aging parents will need help managing their medical appointments and personal care routines. Understanding the best way to offer support in these areas is essential for family caregiver support. Scheduling Medical Appointments: Help your parent schedule and attend medical appointments. Keep a record of their medications, treatments, and doctors recommendations. Assisting with Personal Hygiene: Personal hygiene can become challenging for elderly individuals. Provide respectful assistance with bathing, grooming, and dressing if necessary. Adapting to Changing NeedsAs your parents age, their needs will continue to evolve. Being flexible and adaptable in your caregiving approach is key to providing the best care possible. Monitoring Health Changes: Regularly monitor your parents health and be mindful of any signs of physical or cognitive decline. This will allow you to adjust care plans as needed. Long-Term Care Options: At some point, you may need to explore long-term care options like assisted living or nursing homes if your parents care needs become too demanding. Research these options ahead of time to make informed decisions when the time comes. Addressing Emotional and Social NeedsAging can often lead to feelings of loneliness, isolation, or sadness. Ensuring your parents emotional and social needs are met is just as important as their physical care. Encouraging Social Engagement: Encourage your parents to stay socially active. Whether through community events, senior centers, or simply spending time with family and friends, social interaction is crucial for emotional well-being. Providing Emotional Support: Offer a listening ear when your parents want to talk. Let them express their fears, frustrations, and hopes. Emotional support plays a key role in elderly care. Seeking Outside ResourcesThere are numerous resources available to help family caregivers on their journey. From community services to government programs, finding the right support can alleviate many burdens. Community Resources: Many communities offer resources like meal delivery services, transportation assistance, or in-home care support for elderly individuals. These services can supplement your caregiving efforts. Government Programs: Investigate government programs such as Medicare, Medicaid, or veterans benefits that can help cover some of the costs associated with elderly care. Planning for the FutureWhile its essential to focus on the present, planning for the future is equally important when caring for aging parents. End-of-Life Care: Have conversations with your parents about their end-of-life wishes, including whether they want hospice care or have specific preferences for how they want to spend their final days. Funeral and Estate Planning: These discussions can be difficult, but planning for funeral arrangements and estate distribution will make things easier for the family when the time comes. ConclusionCaring for aging parents is a meaningful and sometimes difficult responsibility. By following these caring for aging parents tips and seeking out elderly care advice, you can ensure that your parents physical, emotional, and social needs are met while also maintaining your own well-being. With a strong support system, open communication, and careful planning, family caregivers can provide the best possible care for their aging loved ones.As you move forward on this journey, remember that family caregiver support is available through community resources, professional services, and the shared experiences of others. By staying informed and prepared, youll be better equipped to provide compassionate and effective care.Need Professional Mental Health Therapy in Salt Lake City, UT?Here at Beacon Therapy of Utah, we understand that life can bring challenges that feel overwhelming, but you dont have to face them alone. Our personalized and compassionate care is here to guide you through those tough times, offering support and tools for emotional healing and personal growth. If youre ready to take the next step toward a healthier, more resilient you, we invite you to reach out and schedule a session with us today. Lets work together to find your path to peace and transformation.