5 ms·

Risk for Dementia May Increase with Long-Term Use of Anticholinergics: Study

31 points by etrevino 7y ago

kenforthewin 7y ago
> It’s possible, for example, that some people taking antidepressants might actually be being treated for what will turn out to be an early symptom of dementia... In short, take these kinds of observational studies with a grain of salt.
- asdfman123 7y ago
  Cool, these medicines I'm taking may or may not ruin my brain forever! The science is not quite in yet. Even though they destroy my short-term memory, in the future, who knows! Boy howdy.
  - Nasrudith 7y ago
    Epistimology is a real pain - unless you can see the future you cannot know except in retrospect. Even the "safe" old option may turn out to not be so with increased understanding so caution in all approaches is advised. We treat cancer with known carcinogens for one.
    - asdfman123 7y ago
      The problem is they pass them out like candy and seem to assure you it's totally okay, but we have no idea what it's actually doing to us. I personally find sleep, exercise and sunlight does far more. However I also understand not everyone is like me. Still, it's kind of crazy.
      - okmokmz 7y ago
        I was amazed how many doctors, therapists, family members, friends, etc. immediately jumped to recommending anti-depressants, anti- anxiety medication, anti-psychotics, or some other medication that will likely have long term or even permanent affects on ones brain after prolonged use rather than attempting to address the root of my issues when I decided to begin seeing a therapist regularly.
JohnJamesRambo 7y ago
Does everyone on HN have NY Times subscriptions? So many articles posted here are from there and I can’t read them without going through lots of hoops.
- supergauntlet 7y ago
  Most sites with soft paywalls you can just open in an incognito window. They're doing it with cookies.
- e40 7y ago
  I think a lot do. I have a digital sub. It's $9.99/mo, but goes up after a year, and when I call to cancel they lower it to $9.99/mo again. The Daily podcast is wonderful. The NYT isn't without fault, but they are probably the best media company in the US.
- organsnyder 7y ago
  I subscribe to the NY Times (and the print edition, anachronistically), as well as a few other outlets. Good journalism costs a lot of money.
- shaki-dora 7y ago
  At $10/month it's really worth it, although you have to remember to cancel and resubscribe after a year. They do an awful lot of important investigative journalism, and I don't want to see what a society without such work looks like.
  - zigzaggy 7y ago
    Interesting post to be getting down voted. I personally don't subscribe, but I value opinions that are different than mine (which include all media outlets, on all sides). I DO subscribe to the Wall Street Journal, which is worth the cost to me. I'm a stock market junkie so there's that.
    - shaki-dora 7y ago
      HN hates the news media and expects hobbyist bloggers and youtubers to become reliable and comprehensive sources of news any day now... I guess people still see the WSJ and NYT on opposite ends of a spectrum. But while the ideological differences persist, I think the more significant difference these days is between reputable outlets and those that are not. On that axis, the WSJ and NYT are both fine, as are a few others.
Bartweiss 7y ago
Most OTC and prescription medicines carry a note along the lines of "the long-term effects of this medication have not been evaluated". When they have, the long-term studies are generally on the order of 2 years, rather than decades. For most medicines, the long-term use risks are probably just hepatic and renal damage, or slow-building tolerance. But we seem to have an increasing list of things which threaten significant indirect dangers over the long term. Anticholinergics, the medicines in the article, have been suspected for quite a while, though proof has been lacking. Acetylcholine is a neurotransmitter, after all, and cholinergics improve brain function in choline-deficient patients. It would almost be surprising if they didn't cause some long-term mental effects. Antihistamines clearly cause short-term sedation and 'brain fog', and are another short-term medicine which many people take regularly for years. I don't know of any equivalent study, but I've heard a number of doctors express concern. Proton-pump inhibitors (i.e. acid reflux meds) are one of the most widely-consumed medications in the US. They've also been linked to dementia in several studies (which are contradicted by several others), and have much less disputed associations with gut bacteria changes that can lead to infection and gastric cancer. Amphetamines (i.e. Adderall) are another obviously-psychoactive medicine studied over short/moderate terms, with primate studies suggesting increased Parkinson's risk at human dosages. This one is a special case, though, because the full risk seems to be incurred after even brief use despite the harms appearing much later. Add to this the stack of worrying-but-vague results showing that many drugs alter gut bacteria, and implicating gut flora in everything from IBS to anxiety to Parkinson's. It increasingly looks like we're running a whole-population study on ourselves, distributing medicines to millions of users with no idea what they do over a lifetime of use. I don't see an obvious cure for this - requiring decades of data before authorizing medications is both unethical and impractical. But long-term drug effects are a disturbingly good explanation for the rising frequency of a whole host of long-term diseases.
hooberscchmit 7y ago
Don't eat Datura every day. Got it.
themodelplumber 7y ago
Can someone please link to the study? I take an anticholinergic and like to stay on top of the latest information. So far the actual study output has been fairly disappointing in quality, and the public rationale for not taking the drug is more subjective-intuitive, getting suppositional and reaching feels-right conclusions when one could reasonably expect hard measurement. I'm not against quitting but I'll be damned if I'm going to take my finger off a button that consistently provides me 8+h sleep and obliterates depression symptoms without being really circumspect about it. Also, no family history of dementia here.
- sampleinajar 7y ago
  https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
  - themodelplumber 7y ago
    Thank you!
- mruts 7y ago
  Is the drug seroquel? I’ve been taking 50-150mg for over 10 years (since I was 15), and am worried about the potential chronic cognitive effects.
dlphn___xyz 7y ago
all the pills in the world cant replace diet and exercise

31 points by etrevino 7y ago

> It’s possible, for example, that some people taking antidepressants might actually be being treated for what will turn out to be an early symptom of dementia... In short, take these kinds of observational studies with a grain of salt.

asdfman123 7y ago
Cool, these medicines I'm taking may or may not ruin my brain forever! The science is not quite in yet. Even though they destroy my short-term memory, in the future, who knows! Boy howdy.
- Nasrudith 7y ago
  Epistimology is a real pain - unless you can see the future you cannot know except in retrospect. Even the "safe" old option may turn out to not be so with increased understanding so caution in all approaches is advised. We treat cancer with known carcinogens for one.
  - asdfman123 7y ago
    The problem is they pass them out like candy and seem to assure you it's totally okay, but we have no idea what it's actually doing to us. I personally find sleep, exercise and sunlight does far more. However I also understand not everyone is like me. Still, it's kind of crazy.
    - okmokmz 7y ago
      I was amazed how many doctors, therapists, family members, friends, etc. immediately jumped to recommending anti-depressants, anti- anxiety medication, anti-psychotics, or some other medication that will likely have long term or even permanent affects on ones brain after prolonged use rather than attempting to address the root of my issues when I decided to begin seeing a therapist regularly.

JohnJamesRambo 7y ago

Does everyone on HN have NY Times subscriptions? So many articles posted here are from there and I can’t read them without going through lots of hoops.

supergauntlet 7y ago
Most sites with soft paywalls you can just open in an incognito window. They're doing it with cookies.
e40 7y ago
I think a lot do. I have a digital sub. It's $9.99/mo, but goes up after a year, and when I call to cancel they lower it to $9.99/mo again. The Daily podcast is wonderful. The NYT isn't without fault, but they are probably the best media company in the US.
organsnyder 7y ago
I subscribe to the NY Times (and the print edition, anachronistically), as well as a few other outlets. Good journalism costs a lot of money.
shaki-dora 7y ago
At $10/month it's really worth it, although you have to remember to cancel and resubscribe after a year. They do an awful lot of important investigative journalism, and I don't want to see what a society without such work looks like.
- zigzaggy 7y ago
  Interesting post to be getting down voted. I personally don't subscribe, but I value opinions that are different than mine (which include all media outlets, on all sides). I DO subscribe to the Wall Street Journal, which is worth the cost to me. I'm a stock market junkie so there's that.
  - shaki-dora 7y ago
    HN hates the news media and expects hobbyist bloggers and youtubers to become reliable and comprehensive sources of news any day now... I guess people still see the WSJ and NYT on opposite ends of a spectrum. But while the ideological differences persist, I think the more significant difference these days is between reputable outlets and those that are not. On that axis, the WSJ and NYT are both fine, as are a few others.

Bartweiss 7y ago

Most OTC and prescription medicines carry a note along the lines of "the long-term effects of this medication have not been evaluated". When they have, the long-term studies are generally on the order of 2 years, rather than decades. For most medicines, the long-term use risks are probably just hepatic and renal damage, or slow-building tolerance. But we seem to have an increasing list of things which threaten significant indirect dangers over the long term. Anticholinergics, the medicines in the article, have been suspected for quite a while, though proof has been lacking. Acetylcholine is a neurotransmitter, after all, and cholinergics improve brain function in choline-deficient patients. It would almost be surprising if they didn't cause some long-term mental effects. Antihistamines clearly cause short-term sedation and 'brain fog', and are another short-term medicine which many people take regularly for years. I don't know of any equivalent study, but I've heard a number of doctors express concern. Proton-pump inhibitors (i.e. acid reflux meds) are one of the most widely-consumed medications in the US. They've also been linked to dementia in several studies (which are contradicted by several others), and have much less disputed associations with gut bacteria changes that can lead to infection and gastric cancer. Amphetamines (i.e. Adderall) are another obviously-psychoactive medicine studied over short/moderate terms, with primate studies suggesting increased Parkinson's risk at human dosages. This one is a special case, though, because the full risk seems to be incurred after even brief use despite the harms appearing much later. Add to this the stack of worrying-but-vague results showing that many drugs alter gut bacteria, and implicating gut flora in everything from IBS to anxiety to Parkinson's. It increasingly looks like we're running a whole-population study on ourselves, distributing medicines to millions of users with no idea what they do over a lifetime of use. I don't see an obvious cure for this - requiring decades of data before authorizing medications is both unethical and impractical. But long-term drug effects are a disturbingly good explanation for the rising frequency of a whole host of long-term diseases.

hooberscchmit 7y ago

Don't eat Datura every day. Got it.

themodelplumber 7y ago

Can someone please link to the study? I take an anticholinergic and like to stay on top of the latest information. So far the actual study output has been fairly disappointing in quality, and the public rationale for not taking the drug is more subjective-intuitive, getting suppositional and reaching feels-right conclusions when one could reasonably expect hard measurement. I'm not against quitting but I'll be damned if I'm going to take my finger off a button that consistently provides me 8+h sleep and obliterates depression symptoms without being really circumspect about it. Also, no family history of dementia here.

sampleinajar 7y ago
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
- themodelplumber 7y ago
  Thank you!
mruts 7y ago
Is the drug seroquel? I’ve been taking 50-150mg for over 10 years (since I was 15), and am worried about the potential chronic cognitive effects.

dlphn___xyz 7y ago

all the pills in the world cant replace diet and exercise