10 Medications That Can Worsen Dementia Symptoms and Should Be Avoided

Certain medications can worsen cognitive decline in people with dementia or
increase the risk of developing dementia, especially in older adults. These effects
are often linked to how the drug impacts brain chemistry, such as blocking
acetylcholine or over-sedating the central nervous system. Always consult a
healthcare provider before stopping or changing any medication.

1. Anticholinergic drugs
These block acetylcholine, a neurotransmitter essential for memory and learning.
Examples include:
• Diphenhydramine (Benadryl, Advil PM, Tylenol PM)
• Chlorpheniramine (Chlor-tab, Aller-Chlor)
• Doxylamine (Unisom)
• Oxybutynin (anticholinergic bladder medication)
• Tricyclic antidepressants (e.g., amitriptyline, nortriptyline)

2. Benzodiazepines
Long-term use (especially >6 months) is linked to up to an 84% higher dementia risk.
Examples:
• Diazepam (Valium)
• Alprazolam (Xanax)
• Lorazepam (Ativan)

3. Antipsychotics
Used in dementia for behavioral issues but carry a high fatality risk. Examples:
• Olanzapine (Zyprexa)

• Risperidone (Risperdal)
• Quetiapine (Seroquel)

4. Corticosteroids
Long-term or high-dose use can impair cognition. Examples:
• Prednisone
• Dexamethasone

5. Beta-blockers
Some studies link long-term use to higher dementia risk, especially in older adults.
Examples:
• Metoprolol
• Atenolol

6. Opioids
Chronic use can contribute to cognitive decline. Examples:
• Oxycodone
• Hydrocodone

7. Proton-pump inhibitors (PPIs)
Long-term use may increase dementia risk, possibly via vitamin B12 deficiency or other
mechanisms. Examples:
• Omeprazole
• Esomeprazole

8. Certain SSRIs
While some SSRIs may reduce dementia risk, others (e.g., citalopram, escitalopram) can
cause sedation or confusion in dementia patients optoceutics.com.

9. Antihistamines (first-generation)
Strong anticholinergics like diphenhydramine and doxylamine can worsen memory and
confusion

10. Some bladder medications
Oxybutynin and other anticholinergics that cross the blood-brain barrier can impair
cognition