memory

Memory, Falls, and Function – Oh Meds!

Posted on by Michelle Fritsch, Pharm.D.
ID-10093880
Medications can make function difficult and lead to memory and falls issues.

If your memory is slipping, do you have dementia? If you fall are you just clumsy? If you need help doing some of your daily tasks, are you just lazy? Or, are these things just a normal part of aging?

I suggest that MANY TIMES, these memory and falls changes are because of medication. Medications can cause these types of issues in a few different ways:

  1. The dose is too high for you.
  2. Your body has trouble getting rid of that medication.
  3. You are on several medications with these types of effects.
  4. Your medications are interacting with each other.
  5. Your medications are interacting with your diet or your other medical conditions.

Medications and Memory and Falls

There are several types of medicines that can fog your thinking. They relax you, make you sleepy, and/or slow your thinking processes. Sometimes you use them for this effect. But know, in making you feel that way, they make it harder to think as quickly and clearly as you normally think.

And by slowing your thinking and response time, they increase your risk of falling, too.

It would be a very long blog to list them all. So, here are some of the more common culprits to impair memory and falls.

  • Anxiety/nerve medications
    • Benzodiazepines (e.g. alprazolam, lorazepam, diazepam)
    • Buspirone (Buspar)
  • Depression medications
    • Tricyclic antidepressants (e.g. amitriptyline, nortriptyline)
    • Selective serotonin reuptake inhibitors (SSRI’s) (e.g. escitalopram, sertraline, fluoxeting)
    • Wellbutrin
    • Buspirone
  • Sleep medications
    • Zolpidem (Ambien)
    • Ramelteon (Rozerem)
    • Eszopiclone (Lunesta)
    • Diphenhydramine (Benadryl, Tylenol PM, Aleve PM)
  • Pain medications
    • Oxycodone
    • Hydrocodone
    • Morphine
    • Hydromorphone
    • Tramadol
  • Anticholinergic medications
    • Incontinence
      • Oxybutynin
      • Darifenacin (Enablex)
      • Solfenacin (Vesicare)
      • Trospium (Sanctura)
      • Tolterodine (Detrol)
    • Parkinson’s Disease (e.g. benztropine, trihexyphenydil)
    • Allergy medications – sedating
      • Diphenhydramine (brand Benadryl)
      • Chlorpheniramine
      • Hydroxyzine
    • Antispasmodic agents (e.g. chlordiazepoxide, belladonna)
    • Diarrhea treatments
    • Muscle relaxants (e.g. cyclobenzaprine, orphenadrine)
    • Dizziness, sea sickness medication (e.g. meclizine, scopolamine)
    • Nausea/vomiting medication (e.g. prochlorperazine, promethazine)
    • Antipsychotic (e.g. thioridazine, chlorpromazine, clozapine, olanzapine)
  • Seizure medication
    • Carbamazepine
    • Valproic acid
    • Several others
  • Nerve pain medication
    • Gabapentin (Neurontin)
    • Pregabalin (Lyrica)

Medications and Function

I have worked with many people who were planning to move to assisted living. They just couldn’t do some of the daily tasks they had done before. These tasks might be cleaning, keeping up with finances, remembering to take medicines, or ability to cook healthy meals.

In many cases, some medication adjustments made a big difference. Assisted living could be delayed.

How do you decrease your risk?

Please NEVER change any medications without first checking with your doctor.

If you take medication that you think could be impacting your clear thinking or make you feel unsteady, talk with your doctor.

If the types of medications mentioned in the blog are going to be changed, make the changes one at a time gradually. Fast changes can be dangerous. Making too many changes at once can make it hard to determine which change works and which doesn’t. So, making these changes should be a slow, careful process.

If you want help –

  • talking with your doctors,
  • coordinating between your doctors, or
  • want to better understand this information

please call us at 410-472-5078 or e-mail at michelle@medsmash.com.

Our website is www.medsmash.com.

BIBLICAL APPLICATION

One of the key ways to prevent falls, medication-induced memory issues, and functional decline is to make sure your primary care physician knows exactly what medications you take and how you take them. Other physicians might contribute to your regimen, but your primary care physician is one who can analyze and control it all.

Similarly, Jesus is your primary spiritual care provider. You have a pastor, teachers, books, TV evangelists, friends, family, and more who contribute to your spiritual care. But, it is Jesus who is at the center.

The best-intentioned specialist medical provider can make a harmful decision because he/she is treating the specialty and less familiar with all of the other aspects of your care.

Similarly, the best-intentioned teacher/friend/colleague can distort the truth of Jesus. This is rarely done intentionally. We can all make mistakes, misinterpret, or be misled.

So, rather than take any teaching by a human at face value, compare it to the TRUTH of God’s Word, the Bible.

John recorded Jesus referring to God’s truth:

John 16:13 ESV

When the Spirit of truth comes, he will guide you into all the truth, for he will not speak on his own authority, but whatever he hears he will speak, and he will declare to you the things that are to come.

John 17:17 ESV

Sanctify them in the truth; your word is truth.

Truth is not something we acquire passively. Just listening to your pastor on Sunday or listening to programs on the radio or TV won’t help you fully understand the truth. Your own reading and studying will give God a chance to talk to you directly. That private time in the Bible can help you recognize truths, understand information, and apply information in a very personal way.

Let your personal Primary Care Spiritual Physician, Jesus Christ, be your primary source of truth. Compare all other teaching to this truth.

2 Timothy 2:15 ESV

Do your best to present yourself to God as one approved, a worker who has no need to be ashamed, rightly handling the word of truth.

Blessings,

Michelle

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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