Taking medication for long-term health problems has made a major contribution to lengthening and improving our lives. In many countries living into the eighties and nineties has become very common. However, drugs can cause side-effects and when doctors prescribe them they know there may be a price to pay.
Here at OurAlzheimer’s we have reported on a number of studies that highlight issues with medications, drug interactions and the difficulties of diagnosing and treating co-existing conditions. The need to minimize harm can be a difficult balance and research such as this does add to the body of knowledge and help improve lives in the long term.
Scientists from the University of East Anglia in the U.K., in the first systematic investigation, looked into the effect medicines have on acetylcholine, a chemical in the brain. The research, published in the Journal of the American Geriatrics Society, found many commonly used drugs, both prescription and non prescription, appear to increase the risk of reduced brain function and cause early death in older people. However, patients have been told not to panic and to continue taking prescribed medication.
The study does highlight the importance for doctors to regularly review drugs taken by elderly patients. It is important that they ensure the risks of side-effects do not outweigh the benefits of taking them and to the need to minimize harm.
Over 80 common drugs were looked at for their anticholinergic effect. The research involved 13,000 men and women aged 65 years and over, for a two year period. They found 20 percent of participants taking drugs with a total asscribed rating scale ACB (AntiCholinergic Burden) of four or more had died by the end of the two-year study, compared with only 7 percent of those taking no anticholinergic drugs. The researchers found for every extra ACB point, the odds of dying increased by 26 percent. Those taking drugs with a combined ACB of five or more scored more than 4 percent lower in a cognitive function tests than those taking no anticholinergic drugs.
The drugs identified include antidepressants such as Elavil, Tryptizol, Laroxyl and Anafranil, the antihistamine Piriton, tranquilisers such as trifluoperazine (Stelazine) the heart drug nifedipine, painkillers such as codeine, asthma treatment beclometasone, and the epilepsy drug Carbamazepine.
The number of medicines taken and the strength of each drug increased the anticholinergic effect, the study found. Based on these findings doctors need to think about avoiding multiple drugs with anticholinergic effects in order to minimize these unwanted problems.