Caution! Medications That Can Cause Cognitive Problems

What Medications Can Cause Cognitive Problems

Doctors have discounted forgetfulness and mental fuzziness as natural aspects of aging. However, scientists now understand that memory loss does not necessarily occur as people age. Indeed, the brain may develop new brain cells and reorganize its connections during life.     

Most individuals are aware of at least some factors that might affect memory, including drug and alcohol misuse, excessive smoking, head trauma, stroke, lack of sleep, extreme stress, vitamin B12 deficiency, and common conditions like Alzheimer’s disease and depression.

But many individuals are unaware that some frequently given medications might affect memory. Continue reading to learn about some of the most cognitive offenders that cause older age problems.

Do Certain Medications Increase Dementia Risk?

You might be worried about your own risk of developing dementia or a loved one’s pharmaceutical regimen, given the accumulating data linking anticholinergic medicines with dementia.

According to a study, those who take an anticholinergic drug family of generic medications for numerous years are more susceptible to dementia as they age.

This theory regarding these medications, used to treat various illnesses ranging from depression to incontinence to epilepsy, is not new. However, the study, which was big in scope and was published in the journal JAMA Internal Medicine, went into greater depth over a longer period than many other studies.

A higher risk of dementia has been related to specific drugs. However, that does not always imply that they cause dementia. Overactive bladder drugs, pain relievers, heartburn meds, and certain anxiety medications have all been linked to an increased risk of dementia.

What medications are we referring to?

The antipsychotic clozapine, the bladder medication darifenacin (marketed as Enablex), the anti-nausea medication scopolamine, the bronchodilator ipratropium, the muscle relaxant tizanidine, the antihistamine diphenhydramine (brand names include Benadryl), and the antidepressants paroxetine, among others, are all anticholinergic medications (brand names include Paxil).

These drugs function by inhibiting acetylcholine, a neurotransmitter involved in numerous nervous system activities, including heart rate, the dilation of blood vessels, breathing, and contractions of the muscles in the stomach during digestion.

Because older persons typically have greater health difficulties, several of these drugs are more likely to be recommended. According to some scientists, older persons may respond more strongly to medications that suppress acetylcholine because they make less of it as they age.

Medications Can Cause Memory Impairment

Learn about drugs that can alter cognition and resemble dementia. Talk to your healthcare professionals if you think medicine is impairing your memory or cognitive abilities.

1. Anxiety medications (Benzodiazepines)

Benzodiazepines are given to treat a range of anxiety disorders, agitation, delirium, and muscle spasms and to avoid seizures. Because they have a soothing effect, benzodiazepines are occasionally used to treat insomnia and the anxiety that might accompany depression.

How they can cause memory loss: Benzodiazepines can impair memory by reducing activity in critical regions of the brain, especially those involved in transferring events from short-term to long-term memory. It is the same reason why benzodiazepines are employed in anesthesia

Patients hardly ever recall any discomfort after an operation once they’ve been given them in addition to the anesthesiologist’s combination of medications. The amnesic effects of midazolam (Versed) are very pronounced.

Alternatives: In my opinion, benzodiazepines should only be used in rare circumstances and for brief periods in older persons. Older persons are more susceptible to memory loss, delirium, falls, fractures, and automobile accidents because older folks take considerably longer than younger people to drain these medicines out of their bodies.

If you use one of these medications for agitation, moderate anxiety, or sleeplessness, talk to your doctor or healthcare provider about other medications or non-drug therapies for your problem. 

Melatonin may be beneficial if you suffer from sleeplessness, for example. When taken before bed in amounts ranging from 3 to 10 mg, Melatonin can aid in reestablishing regular sleep patterns.

2. Anti-epileptic medications

Why they are prescribed: These drugs have long been used to treat seizures, but they are also increasingly recommended for mania, bipolar disorder, nerve pain, and mood disorders.

Memory loss may result from anticonvulsants since they are thought to prevent seizures by slowing the central nervous system’s signal flow. Any medication that reduces CNS signaling has the potential to impair memory.

Alternatives: Phenytoin (Dilantin), which has little to no effect on memory, is effective for many individuals with epilepsy. Venlafaxine (Effexor), a medication that helps preserve memory, effectively reduces the discomfort of many individuals with chronic nerve pain.

3. Medication for depression (Tricyclic antidepressants)

TCAs are used for various conditions, including depression, anxiety disorders, obsessive-compulsive disorder, eating disorders, chronic pain, smoking cessation, and various hormone-mediated conditions, including severe menstrual cramps and hot flashes.

Two of the major chemical messengers in the brain, serotonin, and norepinephrine, are known to be blocked by TCAs, which is why memory issues are thought to result.

Alternatives: Discuss with your medical professional whether non-drug therapy would be more effective than a drug. Altering to a selective serotonin/norepinephrine reuptake inhibitor (SSRI/SNRI) or reducing your dosage are some options you might wish to consider.

4. Medicines for hypertension (Beta-blockers)

Why they are prescribed: Beta-blockers are often used for high blood pressure, congestive heart failure, and irregular heart rhythms because they reduce the heart rate and lower blood pressure. In the form of eye drops they can also be used to treat some forms of glaucoma, as well as migraines, tremors, and angina (chest discomfort).

Beta-blockers are considered to impair memory by hindering (or “blocking”) the actions of important chemical messengers in the brain, such as norepinephrine and epinephrine.

Alternatives: Compared to beta-blockers, benzothiazepine calcium channel blockers are frequently safer and more effective for elderly patients. I suggest speaking with your doctor about the possibility of switching to a carbonic anhydrase inhibitor, such as dorzolamide (Trusopt), if the beta-blocker is being used to treat glaucoma.

5. Antihistamines (First-generation) 

The purpose of their prescription: These drugs are intended to treat or prevent cold and allergy symptoms. Some antihistamines are also used to treat anxiety or sleeplessness, as well as to avoid motion sickness, nausea, vomiting, and vertigo.

The activity of acetylcholine, a chemical messenger that mediates a number of bodily activities, is inhibited by several drugs (prescription and over-the-counter). They prevent the brain’s memory and learning centers from working, which might cause memory loss.

Alternatives: Older people handle newer generation antihistamines like loratadine (Claritin) and cetirizine (Zyrtec) better and do not have the same hazards for memory and cognition.


When an older person takes many drugs for illnesses that can each impact their ability to think clearly, it can be challenging to sort out the potential causes of cognitive changes. Consult your medical professionals if you think that your drugs are impairing your memory or other cognitive abilities. 

They will carefully review the history of your symptoms to understand the most likely causes of the symptoms, reduce or stop taking certain medications, or switch out necessary medications for others with different properties to help determine whether medications are interfering with cognitive functioning.

Further Readings

Cognitive Behavioral Therapy: What Is It and How Does It Function?

Empowering the Elderly: Helping Loved Ones with Cognitive Impairment and Strategies for Supporting Cognitive Function

Caution! Medications That Can Cause Cognitive Problems