These everyday drugs can mimic aging
You’ve probably heard the word “anticholinergic” in television commercials or in one of my articles and mentally checked out because it sounds technical.
Don’t. It’s actually simple. It just means the drug blocks acetylcholine, a chemical messenger that your body uses all day, every day.
Let me boil it down to seven things you should know about acetylcholine before you take a drug that blocks it:
- Acetylcholine keeps your brain sharp and your body regulated.
- Blocking it can mimic aging.
- Some medications are strong blockers and cross into the brain.
- Even mild drugs can add up when stacked together.
- Older adults are especially vulnerable.
- Anticholinergic burden is linked to increased dementia risk.
- Dryness is your biggest clue.
Some drugs have very strong anticholinergic effects. Diphenhydramine (Benadryl), amitriptyline, oxybutynin, cyclobenzaprine and paroxetine are among the bigger offenders. These meds cross into the brain and can noticeably affect cognition, especially in older adults.
Other medications carry milder activity, including newer antihistamines and bladder drugs.
Even when each one seems modest, the cumulative burden adds up. One allergy pill, one bladder medication, one sleep aid, and suddenly acetylcholine is significantly suppressed. Then your mind is affected, or you get constipation and blurry vision.
Older adults should pay the closest attention to changes like this when taking anticholinergic medications. Acetylcholine is central to memory circuits in the hippocampus.
In fact, medications used to treat Alzheimer’s disease (i.e., donepezil) actually work by increasing acetylcholine. Therefore, blocking it chronically can worsen memory and recall and increase dementia risk.
People with dementia, chronic constipation or prostate enlargement are also more vulnerable because anticholinergic drugs can worsen confusion, slow gut motility (increased risk of constipation) and increase urinary retention.
Babies and toddlers can react strongly as well, sometimes with paradoxical agitation.
Check medication labels
How would you know if you were taking an anticholinergic drug? You could ask your local pharmacist, look it up online, or consider the primary side effect: dryness.
Feeling “dry” is one of the biggest clues. Acetylcholine stimulates secretions. When you block it, things dry up. If you have persistent dry mouth, dry eyes, dry skin or constipation, it could be a side effect of your medicine, as opposed to imbalanced hormones or natural aging.
Here’s what I tell people: If you need an antihistamine during peak allergy season, that’s okay. Just don’t live on it for weeks. Use it short-term. If the tablet is scored, sometimes half is enough.
If you have allergies, do saline rinses to bring moisture back. Use a good HEPA filter at home. Shower after high-pollen days so you’re not sleeping in whatever you walked through. If dry mouth kicks in, xylitol lozenges can stimulate saliva.
Your physiology doesn’t care what the drug is for, whether it’s allergies, overactive bladder, sleep or depression. It responds to total chemical load.
Sometimes anticholinergic medication is appropriate. Sometimes it quietly creates brain fog, dryness and slowdown that gets blamed on aging.
If you want a deeper dive and a list of the most common offenders, I’ve posted a longer article at suzycohen.com so you can review your own medication list.
This information is opinion only. It is not intended to treat, cure or diagnose your condition. Consult with your doctor before using any new drug or supplement.
Suzy Cohen is a registered pharmacist and author of The 24-Hour Pharmacist and Real Solutions from Head to Toe.
