Living with the cognitive changes of dementia can be challenging, and certain medications can make your symptoms worse — or may even be their cause.

Dementia is an umbrella term that describes impaired memory loss and changes to cognition in various medical conditions. While it’s commonly associated with older people, dementia isn’t a part of typical aging.

The exact reason why some people develop dementia and some people don’t is unknown, but certain medications may increase your risk.

If you’re already living with dementia, some medications may also worsen your current symptoms.

Medication may be necessary from time to time, especially as you age, but many drugs come with their own set of side effects, some of which can impact your thinking and reasoning.

Taking these medications when you live with dementia may make your symptoms feel like they’re getting worse.

Anticholinergics

Medications that block the neurotransmitter acetylcholine are known as anticholinergic drugs. They have a wide application in the medical world as treatments for respiratory disorders, incontinence, and certain mental health conditions, among many others.

Anticholinergics work well for many conditions because they impact your parasympathetic nervous system, a network of nerves that encourage relaxation and restorative rest.

Dementia is already associated with lowered levels of acetylcholine in the brain, which is why taking anticholinergics — which further restrict acetylcholine — can worsen symptoms.

Common anticholinergics include:

Taking these medications may cause side effects that make dementia symptoms worse such as:

Additionally, a 2018 review of studies found that antipsychotics can increase the risk of death in people with dementia. The article recommended avoiding antipsychotics as a treatment for dementia.

Benzodiazepines

Benzodiazepines are drugs often prescribed to treat insomnia and anxiety. They’re known as depressants, which work by slowing down the function of your central nervous system.

Benzodiazepines have a sedating effect. They can make your thought processes feel slower than typical. These medications can also cause irritability, amnesia, vivid dreams, and hypnosis.

Common benzodiazepine medications include:

  • alprazolam
  • diazepam
  • estazolam
  • flurazepam
  • clonazepam
  • lorazepam
  • temazepam

Corticosteroids

Corticosteroids work throughout your body by mimicking the action of the hormone, cortisol. Cortisol not only helps suppress inflammation but is also an important part of many other biological functions.

One of the potential impacts of corticosteroid use is that of imbalanced neurotransmitters in the brain. Serotonin, norepinephrine, and gamma-aminobutyric acid disruption can lead to symptoms such as:

Common corticosteroids include:

  • cortisone
  • hydrocortisone
  • prednisone

Beta-blockers and statins

Both beta-blockers and statins are medications used in the treatment of cardiovascular diseases. In rare cases, impaired cognitive function has been reported while using these medications.

Chemotherapy drugs

Chemotherapy is known for the side effect casually referred to as “chemo brain,” a mental fogginess that can affect memory and mental acuity.

While it can often be improved after chemotherapy has ended, it may make the symptoms of dementia temporarily more intense.

For many of the same reasons they can make symptoms of dementia worse, certain medications may increase the risk of developing dementia over all.

Anticholinergics

Anticholinergic medications, in particular, have been linked to an increased dementia risk in addition to their ability to exacerbate existing symptoms.

In 2019, a case-controlled study of almost 300,000 medical records spanning more than a decade found anticholinergic medications were associated with a 50% increased chance of developing dementia for people who had been taking those medications daily for at least 3 years.

The study found that out of all anticholinergic drugs, antidepressants, antipsychotics, Parkinson’s medications, epilepsy drugs, and bladder medications carried the highest dementia development risk. However, the study wasn’t able to conclude that anticholinergics directly cause dementia.

Beta-blockers

No large-scale studies have linked beta-blockers to an overall increased chance of developing dementia.

A small 2020 population-based study, however, found beta-blocker use was associated with an increased risk of vascular dementia, a type of dementia caused by changes in blood flow to the brain.

Corticosteroids

Corticosteroid use may result in a type of reversible dementia known as “steroid dementia.” This medication-induced form of cognitive impairment can resolve after stopping corticosteroid use.

Opioids

While opioid use has been primarily an area of concern when it comes to fall risk in dementia, it may also play a role in the development of the condition.

A 2022 study of more than 8,000 people in an Israel healthcare facility found opioid use was associated with an increased risk of dementia development in people between the ages of 75 and 80.

Benzodiazepines

Research on whether or not benzodiazepines can cause dementia is conflicting.

Anxiety and agitation can be early symptoms of dementia. Because of this, it’s unclear if benzodiazepines, which are used to treat these symptoms, can be a cause of dementia or if undiagnosed dementia was the reason for symptoms in the first place.

In 2019, a review of studies found benzodiazepine use, particularly that of long-acting benzodiazepines, significantly increased dementia risk in older adults.

According to research from 2022, however, there appears to be little evidence that supports benzodiazepines as a direct cause of dementia.

Because of the uncertainty, researchers suggest using these medications with caution in older populations.

The underlying causes of dementia will influence how a healthcare team approaches treatment.

For progressive forms of dementia, such as Alzheimer’s disease, the goal of medication is to slow disease progression and improve symptoms.

Medications that can influence the underlying pathology of dementia include anti-amyloid treatments such as:

These medications work by helping remove beta-amyloid in the brain, a protein that accumulates into plaques and disrupts communication between your neurons.

Other medications are there to help improve the symptoms of dementia by stabilizing brain chemicals associated with reasoning, memory, and sleep.

Examples of these medications include:

Certain medications may come with cognitive side effects that can make dementia symptoms worse or increase your chances of developing dementia.

A healthcare team can help you decide if using these medications may be necessary or if safer alternatives are available.