severe insomnia and confusion in elderly

#SEVERE INSOMNIA AND CONFUSION IN ELDERLY PROFESSIONAL#

How they can affect memory: Tricyclic antidepressants block the action of serotonin, norepinephrine and other chemical messengers in the brain, which can lead to a number of side effects, including lapses in memory.Īlternatives: Newer antidepressants like fluoxetine (Prozac), sertraline (Zoloft) and other selective serotonin reuptake inhibitors (SSRIs) don’t have the same anticholinergic effects as tricyclic antidepressants and therefore don’t interfere with cognition, Devanand explains. Why they are prescribed: This older class of antidepressant drugs is prescribed less often these days, but some people still use tricyclics for depression, anxiety disorders, obsessive-compulsive disorder and nerve-related pain.Įxamples: Amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil). Symptoms of cognitive decline are less likely to occur with low doses of antiseizure medicines, Devanand says. Another option: Ask your doctor if adjusting your dosage is a possibility. Patients with chronic nerve pain find that venlafaxine (Effexor) - which also spares memory - alleviates their pain.

One thing to note: These medications can be sedating, “and sometimes it’s hard to separate what is a true cognitive decline from simple sedation,” Devanand says.Īlternatives: Many patients with seizures do well on phenytoin (Dilantin), which, at lower doses, has less of an impact on memory. Drugs that depress signaling in the CNS can cause memory loss. How they can affect memory: Anticonvulsants are believed to limit seizures by dampening the flow of signals within the central nervous system (CNS). Why they are prescribed: Long used to treat seizures, these medications can also be prescribed for nerve pain, bipolar disorder, mood disorders and mania.Įxamples: Acetazolamide (Diamox), carbamazepine (Tegretol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), pregabalin (Lyrica), rufinamide (Banzel), topiramate (Topamax), valproic acid (Depakote) and zonisamide (Zonegran). And those vary from individual to individual,” Lloyd-Jones says. “Any medication can cause any number of different types of side effects. If you have concerns about potential side effects from statins - or any drug - talk to your doctor. In fact, Lloyd-Jones says the data suggests that statins may be protective against cognitive decline, since they are effective at preventing strokes. A 2018 scientific statement from the AHA says there is “no convincing evidence for a causal relationship” between statins and cognitive dysfunction. “Very large studies performed in hundreds of thousands of individuals monitored very carefully do not show any increase in memory problems or anything else related to brain function,” says Donald Lloyd-Jones, M.D., chair of the Department of Preventive Medicine at Northwestern Medicine and immediate past president of the American Heart Association (AHA). Statins appeared in an earlier version of this article, published in 2016, but more recent research is giving these cholesterol-lowering drugs the boot from the list.

#SEVERE INSOMNIA AND CONFUSION IN ELDERLY PROFESSIONAL#

Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process. And an antidepressant might be able to treat your anxiety, Devanand notes.īe sure to consult your health care professional before stopping or reducing the dosage of any benzodiazepine. If you have insomnia, for instance, the first line of treatment is cognitive behavioral therapy for insomnia (CBT-I). If you take one of these meds for insomnia, mild anxiety or agitation, talk with your doctor or other health care professional about treating your condition with other types of drugs or nondrug treatments.

Devanand, M.D., professor of psychiatry and neurology at Columbia University Medical Center. Another drawback: They’re addicting, says D.P. It takes older people much longer than younger people to flush these drugs out of their bodies, and the ensuing buildup puts older adults at higher risk for not just memory loss but delirium, falls, fractures and motor vehicle accidents. In fact, they’re used in anesthesia for this very reason.Īlternatives: Benzodiazepines should be prescribed only rarely in older adults, and then only for short periods of time.

How they can affect memory: Benzodiazepines dampen activity in key parts of the brain, including those involved in the transfer of events from short-term to long-term memory.

Severe insomnia and confusion in elderly