Many commonly used OTC(over the counter drugs) have been linked with dementia(goo.gl/ihYhgc) according to a recent study from the University of Washington Among these are commonly used drugs used in urology and in particular with the IC bladder pain syndrome(interstitial cystitis, vulvodynia, chronic prostatitis, IBS, GERD, and fibromyalgia)
Oxybutynin (Ditropan) and tolterodine (Detrol) have been used for overactive bladder have been linked with dementia in a recent study from the University of Washington These drugs share a common feature with other OTC drugs in that they affect levels of acetylcholine(ACh), a common neurotransmitter in the body The short term changes such as confusion and loss of mental clarity are well known to prescribing physicians but these long term consequences of dementia are not recognized
Alzheimer’s disease is a one of early senility or poor brain function and is associated with very low levels of ACh There is also evidence now that these changes may be irreversible because they produce permanent neurological changes
The relationship to poor brain function and dementia and drugs that control symptoms by lowering levels of ACh should be disturbing to those who rely on these anticholinergic drugs to control their symptoms of the IC bladder pain syndrome
To evaluate whether cumulative anticholinergic use is associated with a higher risk for incident dementia, researchers examined medical records from 3,434 participants 65 years or older with no dementia at study entry Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003 and data through September 30, 2012 were also included in these analyses
Exposure to anticholinergic was determined from computerized pharmacy records Cumulative exposure was updated as participants were followed up over a 10-year period. About 20% of the population was found to be using anticholinergic drugs
During the evaluation period, 797 participants (23.2%) developed dementia with 637 of these (80%) developing Alzheimer disease A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease. In other words, the higher the cumulative anticholinergic use, the greater the increased risk for dementia The highest risk threshold was taking the minimum daily effective dose of one the anticholinergic agents every day for 3 years
Based upon these results, the authors of the study propose efforts to increase awareness among health care professionals and older adults about the risk of the use of these drugs over time Even at low dosage or recommended levels chronic use of these drugs should be avoided
It seems self evident that anticholinergic use that is so prevalent in the IC population keep the use of anticholinergics reduced in treating their symptoms, looking for more alternative ways of managing their symptoms
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