For hundreds of millions of people around the world, allergies are problematic. Whether it’s a frustrating seasonal occurrence or a daily concern of an encounter with a potentially fatal allergen, allergies are not fun. Antihistamines are a medical invention that, for many people, are a total game changer. Whether it’s from something acute like a bee sting or more chronic like pollen allergies, these over-the-counter medications can work wonders. With any medicine, however, there are potential risks. One of these risks, as some studies have found, may be an increased risk of dementia. For people already at higher risk, this could be a big concern. The question that many are asking is should I still be using this medication? This is what the current research says.
How Anticholinergic Drugs Work and Their Impact on the Body
Anticholinergic drugs function by blocking the action of acetylcholine, a neurotransmitter that plays a vital role in transmitting messages within the nervous system. The importance of acetylcholine is particularly highlighted in cognitive functions like learning and memory. Furthermore, in the body, it contributes to stimulating muscle contractions. Common examples of anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications for overactive bladder control, and drugs used to alleviate Parkinson’s disease symptoms. Probably the most common over-the-counter antihistamine that you are familiar with is Benadryl. While these drugs work wonders for helping people manage their allergy symptoms, some researchers are questioning if we should be relying on them so heavily. After all, blocking the action of acetylcholine, which is involved in memory, would surely have consequences if done too often, no? This is exactly what the researchers were wondering. If we use a medication that induces this effect, could this lead to memory-related diseases, aka dementia?
Insights from the Study on Benadryl and Dementia
Research led by Shelley Gray from the University of Washington’s School of Pharmacy followed approximately 3,500 individuals aged 65 and older. All of these individuals participated in the Adult Changes in Thought (ACT) study. The research team analyzed prescription and over-the-counter medication records from Group Health, a Seattle healthcare system, for all of the ACT participants. Over a seven-year period, 800 of the ACT participants developed dementia. The researchers noted that individuals who used anticholinergic drugs had a higher risk of developing dementia compared to the participants who did not use them. Even more interesting, as the dose of these medications increased, so did the risk of developing dementia. They found that individuals who took anticholinergics for more than three years faced a 54% higher risk of dementia. The scientists also established that anticholinergic drugs can induce confusion and an increased risk of falls, particularly in older individuals.
The Impact of Anticholinergics on Cognitive Health
Another study from 2024 published in the Journal of Allergy and Clinical Immunology also found a similar link between anti-allergy medications and dementia. With that, the question still remains: Should we collectively stop using antihistamines and anti-allergy medications? The answer isn’t so black and white. The findings from the ACT study emphasize the growing body of evidence suggesting that anticholinergic drugs, when used long-term, can have detrimental effects on cognitive health and increase the susceptibility to dementia in aging individuals. That being said, there are other studies that haven’t found a significant increase in risk in correlation with these medications. What we do know, however, is that with the natural decline in acetylcholine production as we age, taking medications that further block the effects of the acetylcholine that we have left doesn’t seem like the best idea. Cognitively, anticholinergic medications can manifest side effects like impairments in short-term memory, reasoning, and confusion, along with symptoms such as drowsiness, dry mouth, urine retention, and constipation. When you look at it this way, the answer seems cut and dry: Stop taking all antihistamines immediately! The reality, however, is not so clear.
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Evaluating Your Medications: A Key to Minimizing Risks
The truth of your dementia risk associated with allergy medications depends on you, your family history, and your age. As we age, the way our bodies metabolize medications changes. This makes older adults more sensitive to drug effects. Increased levels of medications in the bloodstream, alterations in body composition, along with the potential interactions between various medications, makes a thorough review and evaluation of all drugs being taken very important. Considering the heightened vulnerability of older individuals to medication-related complications, it is paramount to reassess the necessity and appropriateness of each drug that they are taking. We also know that everything we do when we are younger, including what drugs and medications we take and to what extent, can have a big impact on our health and quality of life when we are older. We might not even see the results of this until decades later. So your risk of taking anti-allergy medications increasing dementia risk when you are older will largely depend on dose and frequency, combined with lifestyle factors, family history, and more.
Mitigating Risks: Alternatives to Anticholinergic Drugs
Given the potential cognitive risks associated with anticholinergic drugs, exploring alternative medications might be the way to go for you. Many researchers are expressing the need for alternative options that don’t affect the brain in this way. If you are someone who has an already increased risk for developing dementia, your doctor may recommend alternatives with lower anticholinergic burden. These could be medications such as selective serotonin reuptake inhibitors (SSRIs) as an alternative to tricyclic antidepressants or newer antihistamines like loratadine as a substitute for the more common diphenhydramine. Additionally, non-pharmacological interventions can be another option for those who may be able to manage symptoms and problems without taking any medications at all. After all, the best solution to any health problem is the one that achieves what you need it too with as few medications as possible.
Seeking Professional Guidance
If you are concerned about your dementia risk, go and speak with your doctor or pharmacists. Gather up all of your prescription and over-the-counter medications and bring them to consultations with your doctor or pharmacist. They can look at your medical history, your current needs, and assess your future risks, along with what medications you are taking. Together, you can effectively pare down the medications you are taking so that you still get the relief that you need, all the while minimizing the risks associated with anticholinergic drugs and all of your other medications, for that matter. This will help to safeguard your cognitive health into older age.
The Bottom Line
The potential link between antihistamines, particularly anticholinergic drugs like Benadryl, and the increased risk of dementia underscores the importance of informed medication choices and frequent medication reviews. This is especially important as we enter into old age. By understanding the impact of anticholinergic drugs on cognitive health and exploring safer alternatives, you can take proactive steps to mitigate risks and protect mental well-being in the long term. As always, if you feel like your concerns are being brushed off, go seek out another opinion. Your cognitive health is too important not to.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
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