
Risk for Dementia May Increase with Long-Term Use of Anticholinergics: Study - etrevino
https://www.nytimes.com/2019/06/25/health/dementia-drugs-anticholinergic.html
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themodelplumber
Can someone please link to the study? I take an anticholinergic and like to
stay on top of the latest information. So far the actual study output has been
fairly disappointing in quality, and the public rationale for not taking the
drug is more subjective-intuitive, getting suppositional and reaching feels-
right conclusions when one could reasonably expect hard measurement.

I'm not against quitting but I'll be damned if I'm going to take my finger off
a button that consistently provides me 8+h sleep and obliterates depression
symptoms without being really circumspect about it. Also, no family history of
dementia here.

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sampleinajar
[https://jamanetwork.com/journals/jamainternalmedicine/fullar...](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353)

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themodelplumber
Thank you!

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Bartweiss
Most OTC and prescription medicines carry a note along the lines of "the long-
term effects of this medication have not been evaluated". When they _have_ ,
the long-term studies are generally on the order of 2 years, rather than
decades. For most medicines, the long-term use risks are probably just hepatic
and renal damage, or slow-building tolerance. But we seem to have an
increasing list of things which threaten significant indirect dangers over the
long term.

Anticholinergics, the medicines in the article, have been suspected for quite
a while, though proof has been lacking. Acetylcholine is a neurotransmitter,
after all, and cholinergics improve brain function in choline-deficient
patients. It would almost be surprising if they _didn 't_ cause some long-term
mental effects.

Antihistamines clearly cause short-term sedation and 'brain fog', and are
another short-term medicine which many people take regularly for years. I
don't know of any equivalent study, but I've heard a number of doctors express
concern.

Proton-pump inhibitors (i.e. acid reflux meds) are one of the most widely-
consumed medications in the US. They've also been linked to dementia in
several studies (which are contradicted by several others), and have much less
disputed associations with gut bacteria changes that can lead to infection and
gastric cancer.

Amphetamines (i.e. Adderall) are another obviously-psychoactive medicine
studied over short/moderate terms, with primate studies suggesting increased
Parkinson's risk at human dosages. This one is a special case, though, because
the full risk seems to be incurred after even brief use despite the harms
appearing much later.

Add to this the stack of worrying-but-vague results showing that many drugs
alter gut bacteria, and implicating gut flora in everything from IBS to
anxiety to Parkinson's.

It increasingly looks like we're running a whole-population study on
ourselves, distributing medicines to millions of users with no idea what they
do over a lifetime of use. I don't see an obvious cure for this - requiring
decades of data before authorizing medications is both unethical and
impractical. But long-term drug effects are a disturbingly good explanation
for the rising frequency of a whole host of long-term diseases.

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kenforthewin
> It’s possible, for example, that some people taking antidepressants might
> actually be being treated for what will turn out to be an early symptom of
> dementia...

In short, take these kinds of observational studies with a grain of salt.

~~~
asdfman123
Cool, these medicines I'm taking may or may not ruin my brain forever! The
science is not quite in yet. Even though they destroy my short-term memory, in
the future, who knows! Boy howdy.

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Nasrudith
Epistimology is a real pain - unless you can see the future you cannot know
except in retrospect. Even the "safe" old option may turn out to not be so
with increased understanding so caution in all approaches is advised. We treat
cancer with known carcinogens for one.

~~~
asdfman123
The problem is they pass them out like candy and seem to assure you it's
totally okay, but we have no idea what it's actually doing to us.

I personally find sleep, exercise and sunlight does far more. However I also
understand not everyone is like me. Still, it's kind of crazy.

~~~
okmokmz
I was amazed how many doctors, therapists, family members, friends, etc.
immediately jumped to recommending anti-depressants, anti- anxiety medication,
anti-psychotics, or some other medication that will likely have long term or
even permanent affects on ones brain after prolonged use rather than
attempting to address the root of my issues when I decided to begin seeing a
therapist regularly.

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hooberscchmit
Don't eat Datura every day. Got it.

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dlphn___xyz
all the pills in the world cant replace diet and exercise

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JohnJamesRambo
Does everyone on HN have NY Times subscriptions? So many articles posted here
are from there and I can’t read them without going through lots of hoops.

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shaki-dora
At $10/month it's really worth it, although you have to remember to cancel and
resubscribe after a year.

They do an awful lot of important investigative journalism, and I don't want
to see what a society without such work looks like.

~~~
zigzaggy
Interesting post to be getting down voted. I personally don't subscribe, but I
value opinions that are different than mine (which include all media outlets,
on all sides).

I DO subscribe to the Wall Street Journal, which is worth the cost to me. I'm
a stock market junkie so there's that.

~~~
shaki-dora
HN hates the news media and expects hobbyist bloggers and youtubers to become
reliable and comprehensive sources of news any day now...

I guess people still see the WSJ and NYT on opposite ends of a spectrum. But
while the ideological differences persist, I think the more significant
difference these days is between reputable outlets and those that are not. On
that axis, the WSJ and NYT are both fine, as are a few others.

