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PSA 50% increase in dementia tied to anticholinergic drugs in older adults

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25 June 2019, 01:08 PM
Amanda
PSA 50% increase in dementia tied to anticholinergic drugs in older adults
Not THAT "old".
I think the age cohort includes many/most of us (55 and up), and I don't know about you but I've been taking at least one of the meds they highlight - for me, Baclofen for night-time muscle spasms. (I think I'll switch to an OTC med whose active ingredient is quinine.)

I'm almost glad to have treatment-resistent depression as anti-depressents are a prime suspect
(now THAT IS depressing!). Many other commonly prescribed too (meds listed).

Frowner

50% more older people tend to dementia from anticholinergics


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The most dangerous word in the language is "obvious"

25 June 2019, 03:46 PM
piqué
I took baclofen for years and it didnt help much compared to what i take now--magnesium glycinate powder, 1500 mg before bed.


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25 June 2019, 04:25 PM
ShiroKuro
But the study didn't find causation, only correlation. Maybe people with those conditions are predisposed to dementia and it's not because of the drugs...


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25 June 2019, 05:04 PM
Amanda
quote:
Originally posted by piqué:
I took baclofen for years and it didnt help much compared to what i take now--magnesium glycinate powder, 1500 mg before bed.


Thank YOU, PK! I've also heard magnesium can help and, in fact, I got some magnesium supplements (don't know how dosage compares to yours) and have been taking it irregularly.

Now, I'll try it more attentively and try to notice its effectivenesss for me.


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The most dangerous word in the language is "obvious"

25 June 2019, 05:11 PM
Amanda
quote:
Originally posted by ShiroKuro:
But the study didn't find causation, only correlation. Maybe people with those conditions are predisposed to dementia and it's not because of the drugs...


True, but the numbers with dementia who've been taking the dosages sounds very persuasive to me. Not going to wait for some double blind longitudinal study to prove causality for sure*.

This isn't a new observation, but this time the connection is much more clear - so much so, they can separate degree of risk by anticholinergic medication class.

*Hopefully, DNA studies can soon give more immediate information about relationships between meds and gene structure. There's a new(ish) test to this end called "Genesight", if only (unsure) fot antidepressents. I'm very interested.
Note, they cite a very real possibility that 10% of Alzheimers' patients were precipitated by anticholinergics. Yes, I would like to see the studies more fine-tuned.

PS I doubt the diseases entities cited themselves predispose to Alzheimer's. They are so unrelated.


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The most dangerous word in the language is "obvious"

25 June 2019, 06:57 PM
Nina
The difficult thing, in my opinion, would be to find the balance between quality of life and dementia concerns. Some of those anticholinergic drugs are treating fairly significant issues (like clinical depression, schizophrenia, parkinson's,etc.). Others (like dramamine, Advil PM, etc.) are perhaps not as clinically necessary in order to improve an individual's quality of life.

I could easily see a situation where a person would be willing to take on a higher risk of dementia in order to lead a more fulfilling life.
25 June 2019, 11:45 PM
Amanda
If possible, it's an even greater incentive to work on non-anti-cholinergic anti-depressent classes.

Ketamine, buprenorphine and glutamate-pathway studies look very promising and personally I really resent the extreme pull-back on prescribing of those in the MAO inhibitor class. (It's entirely a liability concern because if the patient isn't diligent about eliminating certain "tyramine sensitive" foods, they run the risk of a hypertensive crisis.)

Well, speaking as someone who WAS diligent, and had a fabulous antidepressent response. I think it's a crime so many patients completely lose out on this class which have saved many more lives. When they work (often), they are much more effective than tricyclics.

WELL, LET THE PATIENT DECIDE WHETHER OR NOT TO FOLLOW THE DIET! (I say if someone isn't willing to do without cheese and pastrami, they aren't really depressed. Blink )

(Note that MAO inhibitors happen to be much cheaper!)

If anybody wonders why I still complain of depression. it's because I developed a different rare (intolerable) side effect and had to discontinue my MAO inhibitor.

Frowner

Most people I know who take antidepressents, aren't thrilled by them (especially because of the bad effects on libido and weight gain). It's just slightly better netto than their depression.
Given the apparent added risk of dementia (which may be quite pronounced), it may tip the scales for them against continuing. They should certainly be informed, especially marginal responders.


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The most dangerous word in the language is "obvious"

26 June 2019, 01:06 AM
Steve Miller
quote:
Originally posted by Amanda:
quote:
Originally posted by piqué:
I took baclofen for years and it didnt help much compared to what i take now--magnesium glycinate powder, 1500 mg before bed.


Thank YOU, PK! I've also heard magnesium can help and, in fact, I got some magnesium supplements (don't know how dosage compares to yours) and have been taking it irregularly.

Now, I'll try it more attentively and try to notice its effectivenesss for me.


Magnesium works for me and it’s really, really cheap.


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