Published: Fri, April 27, 2018
Medical | By Mark Scott

Antidepressants, incontinence drugs linked to dementia in research

Antidepressants, incontinence drugs linked to dementia in research

They looked back at prescribing records for up to 20 years earlier, to find out whether there was a link between the anticholinergic drugs they were given and a later diagnosis of dementia.

The researchers found that people who used certain types of anticholinergics, such as those used to treat depression, Parkinson's and urinary incontinence, for a year or more had about a 30% increased risk of developing dementia down the road.

"Clinicians should continue to be vigilant with respect to the use of anticholinergic drugs, and should consider the risk of long-term cognitive effects, as well as short-term effects, associated with specific drug classes when performing their risk-benefit analysis".

However several other anticholinergic medications, including anti-histamines and those used for abdominal cramps, were not found to be linked to dementia - despite previous research suggesting that any anticholinergic might represent a risk. Are you concerned your medication could be increasing your risk of dementia?

Using anticholinergic medications over depression promotes higher dementia risks, confirmed by the researchers from the University of East Anglia after analyzing the patients who had always been suffering through Parkinson's disease, depression or bladder conditions and prescribed with heavy dosage of certain anticholinergics.

In contrast there was no association between dementia risk and the historical use of antispasmodic, antipsychotic, antihistamine or other drugs with a similar ACB score of 3. "Many of these medicines will have some anticholinergic activity and, in the light of today's findings, we have to consider whether the risks of dementia outweigh the benefits from taking a cocktail of prescribed drugs". It could be that these medications are being prescribed for very early symptoms indicating the onset of dementia. Patients who took anticholinergics - which work by blocking a key neurotransmitter in the body called acetylcholine - for more than a year had around a 30 peer cent increased risk of dementia, researchers said. "And we found that about 9% of our (dementia) cases had taken anticholinergics in the past, compared to about 6% of our controls". Researchers compared the records to those of over 283,000 people without dementia to determine risk, according to the BBC.

It also analysed more than 27 million prescriptions - making it the biggest study of its kind into the long-term impact of anticholinergic drugs in relation to dementia.

The researchers, led by the University of East Anglia, stop short of claiming that the drugs cause dementia. "Don't stop taking your medication".

But particularly as treatment options for many conditions increase, the study adds more weight to the notion that physicians should be proactive about identifying alternatives to anticholinergic medications whenever possible, according to Dr. Chris Fox, a clinical senior lecturer at Norwich Medical School and a lead author on the study. The warning to not use anticholinergic drugs in Parkinson's disease is also important. Nevertheless, the team claims, the findings are signficant enough to warrant reduced prescribing anticholinergics, where possible "With many medicines having some anticholinergic activity, one key focus should be de-prescribing", states study co-researcher Ian Maidment, Ph.D., senior lecturer in clinical pharmacy at Aston University in the United Kingdom. This type of study imagines that patients actually take their drugs as they were prescribed for them.

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