memory decline

Are you meds making your memory better or worse?

Your Medications and Your Memory – making things better or worse?

Posted on by Michelle Fritsch, Pharm.D.
Are you meds making your memory better or worse?
Memory

Do you ever feel like your memory is slipping? Are you getting forgetful?

Prescription Medications and Memory

Which of your medicines is helping preserve your memory? There are several medical conditions that can make your memory worse. The medicines that treat those conditions then help preserve your memory. Some examples include medicines for heart disease, seizures, blood thinners, asthma inhalers, or emphysema and bronchitis inhalers. Oxygen is a common theme with many of these medications. If you have a medical condition that could decrease the oxygen getting to your brain, this could worsen your memory.

Which of your medicines is actually making your memory worse? Unfortunately, there are many medications that can do this. Any medication that can make you sleepy or slow your thinking can make it harder to remember things. Any medicine that impacts how your brain functions can alter clear thinking. This does not mean all of these medications should be avoided. It does mean to not assume you have dementia when you have foggy thinking while on these medications. There are many examples; some common ones are medications for pain, anxiety, and depression. Anticholinergic, or very drying, medicines cloud your thinking. Recently, statin medications for cholesterol have also been associated with memory impairment.

There are currently two classes of medicines approved for use in Alzheimer’s Disease. For many medical conditions, once diagnosed, you are prescribed a medication(s) to treat that condition. This is not as simple with the dementia medications. They do NOT cure or prevent dementia. They do NOT help all people with dementia. The best impact they have is to slow the progression of dementia, and again, not everyone who takes them will have this result. They have cholinergic side effects that include nausea and diarrhea. If they are stopped after they have been taken, there can be a rapid decline in the dementia. It is not known if the decline is to the point the person would have been if they had not taken the medicine, or if it is an even sharper decline. So there is much to discuss with your physician and healthcare team before deciding to take these medicines.

How about vitamins?

Vitamins are perfectly safe, right? The more the better, right? For many vitamins, taking more than you need is just a waste; your body gets rid of what it doesn’t need. But some other vitamins are not easily cleared, and too much can cause problems. Vitamin E is a vitamin that has been studied to see if it can help with memory. Although some studies have had mixed results, there is no evidence that vitamin E can prevent dementia. There is some data that suggests it might help slow the progression of Alzheimer’s disease. But, there have also been reports of increased risk of death with vitamin E. This is because it can interact with several medications, especially those that can cause bleeding such as medicines that prevent clots. It is also one of the vitamins that the body can’t easily expel, so it is possible to get too much.

Vitamin B12 is another that has been studied.  If your vitamin level is low, then vitamin B12 can help.  However, if your B12 level is normal  supplements will not help.

The best way to get vitamins is through your diet.

And what about herbal remedies, natural remedies, or supplements?

There have been some studies looking at gingko biloba. It does not appear to prevent Alzheimer’s or other forms of dementia. There is some data that suggests it might help stabilize dementia. In particular, some studies show that it can help stabilize mood. Healthy people who take gingko report feeling more alert. However, there are several medication interactions to consider before you take this. It can increase risk of bleeding and can impact blood sugar control if you have diabetes.

Other substances that will change your ability to think clearly are alcohol, marijuana, and illicit substances. They may not be prescribed (yet), but they can definitely impact how sharply you think. Include these when you talk with your physician and your pharmacist about your medicines.

Some medications can help preserve your memory, and some medications can make your memory worse. Vitamins, over-the-counter medicines, supplements, and herbal remedies all should be considered medications. Share all that you take with your primary care provider and your pharmacist. That will allow them to make sure there are no medicines or interactions that are negatively changing your memory.

For more information about your medications and your memory, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as medication can cloud our thinking and memory, what can cloud our spiritual life? Do you ever feel that you are just not fully connected with God? Does it ever feel like something is clouding the connection? Or do you find it’s easier to just ignore the connection?

In my life the most common culprits are:

  • To-do lists
  • Crazy schedules
  • Worries

Martha got caught up in similar tasks. She was fretting so much about hosting Jesus that she failed to experience Jesus.

Luke 10:38-42 ESV

Now as they went on their way, Jesus entered a village. And a woman named Martha welcomed him into her house. And she had a sister called Mary, who sat at the Lord’s feet and listened to his teaching. But Martha was distracted with much serving. And she went up to him and said, “Lord, do you not care that my sister has left me to serve alone? Tell her then to help me.” But the Lord answered her, “Martha, Martha, you are anxious and troubled about many things, but one thing is necessary. Mary has chosen the good portion, which will not be taken away from her.”

There are several verses that help us realign our thoughts and hearts.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.

1 John 2:17 ESV

And the world is passing away along with its desires, but whoever does the will of God abides forever.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

To use a sports analogy, keep your eyes up and focused on the long game. Daily struggles become easier to navigate when your focus is on God. He will lead you step by step according to His plan for you.

For it is impossible to be in the presence of Jesus and not be changed.  

– Joanne Weaver

This might sound contrite, but truly give your day to Him, keep your focus on Him, and see what happens.

Blessings,

Michelle

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Medications to avoid when over age 65

Posted on by Michelle Fritsch, Pharm.D.

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Since 1991 there has been a group of geriatricians and other physicians identifying medicines that might be inappropriate in people over age 65. Dr. Mark Beers originally led this group, so it is called the ‘Beers Criteria’. This list has been updated every few years. The most recent update was this month.

The medications on this list have SAFER and/or MORE EFFECTIVE options available.

Some of the reasons for medications to make the list include:

  • blood pressure lowering medicines that cause more dizziness and falls than other options
  • medicines with anticholinergic (very drying) effects that can have several negative effects including worsening memory
  • anxiety medicines that cause thinking/memory problems and falls
  • depression medicines that cause several problems
  • allergy medicines that cause drowsiness, driving accidents, and falls
  • medicines that are cleared from the body through the kidneys which slow down with age
  • medicines that are cleared from the body through the liver which can slow down with age
  • medicines that are ok at low doses but dangerous at high doses
  • medicines that can cause delirium
  • medicines that can worsen memory
  • medicines that can cause constipation
  • medicines that can make urination with prostate enlargement even more difficult

This year, for the first time, guidelines for safer options to replace these dangerous medicines were written. This is exciting news!

If you are over 65, please talk with your prescribers about these lists of potentially inappropriate medicines and these lists of safe alternatives.

For a personal evaluation of your medicines, please contact www.medsmash.com.

Biblical Application

In your daily walk with God, what are the most effective steps and activities? What does the Bible say you should do regularly?

And, where are the pitfalls? What should you avoid?

Just as the Beers List guides prescribers to select the most beneficial and safest medicines, the Bible guides our spiritual practices. Your heart, your tongue, your thoughts, your study, your time, and your actions are included in this guidance.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Colossians 3:5-10 ESV

Put to death therefore what is earthly in you: sexual immorality, impurity, passion, evil desire, and covetousness, which is idolatry. On account of these the wrath of God is coming. In these you too once walked, when you were living in them. But now you must put them all away: anger, wrath, malice, slander, and obscene talk from your mouth. Do not lie to one another, seeing that you have put off the old self with its practices and have put on the new self, which is being renewed in knowledge after the image of its creator.

James 1:19-20 ESV

Know this, my beloved brothers: let every person be quick to hear, slow to speak, slow to anger; for the anger of man does not produce the righteousness of God.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

James 1:22-27 ESV

But be doers of the word, and not hearers only, deceiving yourselves. For if anyone is a hearer of the word and not a doer, he is like a man who looks intently at his natural face in a mirror. For he looks at himself and goes away and at once forgets what he was like. But the one who looks into the perfect law, the law of liberty, and perseveres, being no hearer who forgets but a doer who acts, he will be blessed in his doing. If anyone thinks he is religious and does not bridle his tongue but deceives his heart, this person’s religion is worthless. Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction, and to keep oneself unstained from the world.

There are certainly many more verses that guide our lives. These can be a start in developing a strategy to avoid inappropriate, dangerous behaviors and replace them with life-giving, holy options.

Blessings,

Michelle

Life Transitions = Depression Risk

Posted on by Michelle Fritsch, Pharm.D.

car-clip-art-879As my son returns to college I am fighting tears and happy at the same time. It is such a big adjustment to be away from him for several weeks at a time. I am sitting here thinking about the big impact of life transitions. We all experience them.

It is common knowledge that loss of a loved one and tragedies can increase risk of depression.

Moving, marriage, child moving out, job loss, retirement, and functional changes can increase risk of depression.

Diagnosis with a chronic illness can increase risk of depression.

As age increases, these life transitions can become more frequent.

When not recognized and addressed, depression can make you feel tired with too little energy, make it hard to concentrate and cause you to lose interest in things that you used to enjoy. It can also lead to you feeling sad and hopeless.

Depression is NOT a normal part of aging.

You do NOT have to just tolerate it and think this is your new normal.

Depression does NOT mean you have done something wrong.

There is help, and there is hope! Effective depression treatment usually requires support from people and medications. Medications that treat depression take about 8 weeks to work, so please be patient and take them every day until they work.

To further complicate things, depression is common in someone experiencing memory decline. As stated above, depression makes it harder to concentrate and remember. Cognitive or memory decline often leads to depression as the decline is recognized. Professional diagnosis and treatment is imperative to sort through what is causing what symptoms and the best course of action.

Remember, you do not have to live with depression.

If you’re interested in a depression screening, contact www.medsmash.com.

Biblical Application

If you are depressed, are you a bad person? NO!

Are you a weak Christian? NO!

Have you done something wrong? NO!

Throughout the Bible there are stories of people dealing with difficult situations, life transitions, illnesses, chronic problems. These include David and Paul and Joseph. You are not alone.

Also found throughout the Bible are messages about joy and hope. You have an eternal source of this joy and hope.

I believe part of God’s design for helping you through these difficult times is medical and psychological treatment. God gave these abilities and resources to your treatment team for your benefit.

Psalm 28:7 (NLT)

The Lord is my strength and shield.

I trust him with all my heart.

He helps me, and my heart is filled with joy.

I burst out in songs of thanksgiving.

Hebrews 6:19 (CEV)

This hope is like a firm and steady anchor for our souls. In fact, hope reaches behind the curtain and into the most holy place.

Romans 12:12 (NLT)

Rejoice in our confident hope. Be patient in trouble, and keep on praying.

I’ll be praying you find the eternal joy that is yours in Christ. And I encourage you to seek God’s blessing through treatment by your healthcare providers.

Blessings,

Michelle