
Dementia 'linked' to common over-the-counter drugs - k-mcgrady
http://www.bbc.co.uk/news/health-30988643
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matznerd
Is it that surprising that inhibiting choline would be a bad idea? Choline's
positive effects on memory and the brain are very well known and increases in
acetylcholine are one of the main methods of actions of nootropics in the
racetam class.

Profound effects of combining choline and piracetam on memory enhancement and
cholinergic function in aged rats.
[http://www.ncbi.nlm.nih.gov/pubmed/7301036](http://www.ncbi.nlm.nih.gov/pubmed/7301036)

Effects of citicholine and of the combination citicholine + piracetam on the
memory (experiments on mice).
[http://www.ncbi.nlm.nih.gov/pubmed/2392950](http://www.ncbi.nlm.nih.gov/pubmed/2392950)

Comparative studies on the effects of the nootropic drugs adafenoxate,
meclofenoxate and piracetam, and of citicholine on scopolamine-impaired
memory, exploratory behavior and physical capabilities (experiments on rats
and mice).
[http://www.ncbi.nlm.nih.gov/pubmed/3136617](http://www.ncbi.nlm.nih.gov/pubmed/3136617)

~~~
metamet
And people have been told to avoid egg yolks since the whole Ancel Keys
debacle.

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slavik81
This study might not be the final word, but as someone who has taken quite a
few antihistamine pills over the years, I was certainly a little concerned
upon seeing hay-fever mentioned. I'm glad to see that the medication I took is
a little different from the ones in the study.

From the article:

> A study has linked commonly used medicines, including over-the-counter
> treatments for conditions such as insomnia and hay-fever, to dementia.

> All of the types of medication in question are drugs that have an
> "anticholinergic" effect.

From Wikipedia: [1]

> Cetirizine /sɛˈtɪrɨziːn/ (trade names Zyrtec, Reactine).

> Unlike many other antihistamines, Cetirizine does not exhibit
> anticholinergic properties.

[1]
[http://en.wikipedia.org/wiki/Cetirizine](http://en.wikipedia.org/wiki/Cetirizine)

~~~
fensipens
Let me complement your helpful answer with some details about the stuff I'm
eating..

Fexofenadine (Allegra, Telfast..):

"Unlike older antihistamines, fexofenadine does not have anticholinergic
activity."
[http://www.medscape.com/viewarticle/406437_3](http://www.medscape.com/viewarticle/406437_3)

Bilastine (Bilaxten):

"No anticholinergic adverse events were observed in the clinical trials.."
[http://en.wikipedia.org/wiki/Bilastine](http://en.wikipedia.org/wiki/Bilastine)

"bilastine's safety profile is satisfactory, since it lacks anticholinergic
effects"
[http://www.ncbi.nlm.nih.gov/pubmed/22149338](http://www.ncbi.nlm.nih.gov/pubmed/22149338)

~~~
Moru
Thankyou, I was just about to search for Allegra, my current favourite.

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eurleif
I wonder if choline supplementation would counteract this effect. In fact, I
wonder if choline supplementation might help stave off dementia in general. As
much as 90% of the population may be deficient in choline.[0]

[0]
[http://en.wikipedia.org/wiki/Choline#Groups_at_risk_for_chol...](http://en.wikipedia.org/wiki/Choline#Groups_at_risk_for_choline_deficiency)

~~~
mmanfrin
(Wild speculation ahead)

I think it has to -- almost all of the nootropics that people use (-iracetams)
are recommended to be taken with choline supplements, as people tend to get
headaches without them. These nootropics were looked at as Alzheimer-
preventing or -delaying drugs, and they cause an uptick in choline use that
necessitates the supplements. I feel that indicates choline is used in keeping
the mind strong against Alzheimers.

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omgitstom
There is still so much that we do not understand about the brain and its
diseases.

When we find the source of dementia, alzheimer, etc, I won't be surprised if
very common activities put people at higher risk. Artificial sweeteners, OTC
drugs, THC, and drinking water out of plastic bottles can all be 'linked' to
brain diseases in a similar fashion to the study mentioned in the article.
__Correlation does not imply causation__.

I think the important stat out of this article is that over ~20% of people in
the study ended up developing dementia. It is hard to compare this with past
trends because we didn't understand brain diseases like we are understanding
them today, but that is extremely scary for an aging population.

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ggchappell
This is apparently a new study, but the idea is not new. For example, see this
article from American Family Physician in 2009:
[http://www.aafp.org/afp/2009/0301/ot2.html](http://www.aafp.org/afp/2009/0301/ot2.html)

A quote:

> Background: Medications with anticholinergic properties are often associated
> with adverse events, including falls, cognitive dysfunction, delirium, and
> loss of independence.

That's from 2009, and it is stated as something already known.

Also, it should be noted that loratadine ("Claritin"), which _lots_ of people
take, has anticholinergic effects. See
[http://doctorslounge.com/chest/drugs/antihistamines/claritin...](http://doctorslounge.com/chest/drugs/antihistamines/claritin.htm)

~~~
jcl
That's weird... The following article has a quote from one of the dementia
study authors that specifically calls out loratadine/Claratin as an
antihistamine that does _not_ have anticholinergic effects:

[http://www.telegraph.co.uk/news/science/science-
news/1137023...](http://www.telegraph.co.uk/news/science/science-
news/11370231/Drugs-like-Nytol-and-Piriton-raise-risk-of-Alzheimers-disease-
say-scientists.html)

~~~
aydinhan
This article examines and compares the anticholinergic effects of
antihistamine drugs. It seems that loratadine has an anticholinergic potency
greater than chlorpheniramine which is one of the experimented drugs in the
study.

[http://www.ncbi.nlm.nih.gov/pubmed/15627436](http://www.ncbi.nlm.nih.gov/pubmed/15627436)

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totony
I agree with not using drugs except if necessary (i.e. not a simple cold).

Also, I hate when an article has the word "scientists" with the quoted work
"linked". Looks too much like click baiting.

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spo8
As someone who takes ~70mg of diphenhydramine per night to help with insomnia,
this is terrifying to me.

~~~
Alex3917
Doesn't that not even work better than placebo after a few days?

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Zaheer
I stopped taking over-the-counter drugs years ago unless its vitally
necessary. Common colds, allergies etc are not too difficult to bear in most
circumstances and with the all the side-effects of pharma drugs I prefer to go
with alternative medicines ex. local honey, lemons, etc.

~~~
pdabbadabba
> I prefer to go with alternative medicines ex. local honey, lemons, etc.

These alternatives clearly have the advantage of being side-effect free for
most people, but I have always been very skeptical about their effectiveness.
Are there actually any reliable studies on the efficacy of local honey in
treating allergies? And I thought that the role of vitamin C in warding off
colds had been pretty well debunked. (I assume that's what the lemons are
for.)

Don't get me wrong, I really _wish_ all this nice stuff worked. Show me firm
evidence that it does, and I'm sold. (And some of it I'm happy to do even if
it's _not_ effective in the pharmacological sense, just because it
feels/tastes nice.) But as I said, I'm skeptical.

~~~
k-mcgrady
I agree with the parent when it comes to things like the cold. I seriously
don't understand people who take paracetamol and tons of other over the
counter stuff for that. When it comes to allergies though (hay fever in my
case) I can barely function without antihistamines (and with them I'm still a
wreck). I haven't found any of the home remedies to be effective for it
whereas in the case of the cold plenty of water and some lemon and ginger tea
seems to improve things a bit. In fact I've noticed I feel better with that
than over the counter stuff for the cold.

~~~
aidenn0
My wife will reliably get acute sinus infections following a cold if she
doesn't take decongestants. She is generally aversive to taking any
medication, but after 8 sinus infections in one year, she now always takes
decongestants when a cold starts.

~~~
mrfusion
I'm thinking I might have that same issue. Can you share what works for her?

~~~
silencio
I'm not the parent, and I haven't had 8 in one year, but I've had a few, and
my colds always come with congestion...

I use the hell out of neti pots/sinus rinses, steam inhalation (like a cup of
tea - which, drinking lots of fluids also helps), and pseudoephedrine.

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arvinjoar
The study[1], if anyone is interested. I couldn't gain free access through my
university it seems, oh well.

[1] =
[http://archinte.jamanetwork.com/article.aspx?articleid=20917...](http://archinte.jamanetwork.com/article.aspx?articleid=2091745)

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girvo
Somewhat unsurprising to me. I once accidentally overdosed on an
anticholinergic drug, and it was the most unpleasant experience of my life. It
was a combination of psychosis and hallucinations coupled with what I imagine
dementia to be like. Hideous. Of course, expect the two to be linked in the
long term is ridiculous on my behalf, but if it can have that effect in the
short term...

~~~
giggles_giggles
For what it's worth, diphenhydramine (mentioned in the article) is Benadryl,
and it's widely known that it causes hallucinations in high doses:

[https://www.erowid.org/pharms/diphenhydramine/diphenhydramin...](https://www.erowid.org/pharms/diphenhydramine/diphenhydramine_effects.shtml#description)

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api
"Linked..."

