April 1, 2009
Drug-Induced Dementia and Delirium Common in Seniors But Often Undetected, Public Citizen Says
Condition Is Usually Reversible, Can Be Caused by 136 Drugs Listed on WorstPills.org
WASHINGTON, D.C. – Older patients become more susceptible to drug-induced dementia and delirium as they age, but the symptoms are often overlooked by doctors who don’t realize that the condition may be caused by drugs and reversed, Public Citizen writes in a Worst Pills, Best Pills News article released today on WorstPills.org, the organization’s drug safety Web site.
Unlike most forms of dementia, such as Alzheimer’s disease, which cannot be reversed, dementia caused by prescription drug use may be stopped by discontinuing the offending medication. The drug safety experts at Public Citizen have identified 136 commonly prescribed medications, especially certain antidepressants and pain medications, that can cause difficulty thinking.
Drug-induced dementia and delirium are commonly misattributed to underlying medical illness or merely to “old age.” But by stopping or modifying the dosage of numerous, frequently prescribed drugs, most patients can be restored to a pre-drug state of mental clarity.
Older people are more susceptible to drug-induced delirium and dementia because the body’s ability to rid itself of drugs decreases with age, often because of normal age-related decrease in kidney and liver function. Also, older patients are often prescribed multiple drugs at the same time, resulting in complicated interactions and enhanced side effects. Some research also suggests older patients’ brains may be more sensitive to drugs’ effects on the central nervous system.
“Sadly, doctors don’t always recognize cognitive impairment as a side effect, so many patients needlessly suffer from this debilitating but reversible condition,” said Sidney Wolfe, M.D., director of Public Citizen’s Health Research Group and acting Public Citizen president. “After beginning new drugs, doctors, patients and their families should watch for subtle changes in cognition and assume changes may be caused by drug therapy. People already suffering from some cognitive impairment are most susceptible.”
Delirium is a syndrome of changes in vision, hearing and thinking that usually starts abruptly and is commonly seen in the hospital setting or during an acute illness; symptoms typically improve when the cause is treated. Dementia, on the other hand, is a chronic alteration in thinking that progresses slowly. Alzheimer’s disease is dementia’s most common cause, but it also can be caused by strokes and other conditions.
WorstPills.org includes the full list of 136 implicated drugs. Some examples include: widely used antihistamines such as diphenhydramine (Benedryl); a drug widely used for treating urinary incontinence, tolteridine (Detrol); a nausea treatment drug, metoclopramide (Reglan); and drugs in the non-benzodiazepine category such as popular sleeping pills Ambien (zolpidem) and Lunesta (eszopiclone).
Worst Pills, Best Pills News is a monthly newsletter available in print and electronic formats through Public Citizen’s subscription Web site, . The article about drug-induced dementia and delirium will be available free for the next seven days. The site has other searchable information about the uses, risks and side effects associated with prescription medications.
WorstPills.org is an unbiased analysis of information from a variety of sources, including well-regarded medical journals and unpublished data obtained from the Food and Drug Administration, that allows Public Citizen to sound the alarm about potentially dangerous drugs long before they are banned by the federal government and to recommend safer drugs. For example, Public Citizen warned consumers about the dangers of Vioxx, ephedra, Baycol and Propulsid years before they were pulled from the market.