Older adults who use bladder controlling anticholinergic drugs such as Ditropan, Detrol, Enablex, Toviaz, Sanctura and Vesicare may want to talk with their doctor about finding an alternative. According to a study published by the Journal of the American Medical Association on April 18, these drugs may cause brain damage, cognitive impairment and dementia even after only being used for as few as 60 days. Other anticholinergic drugs include over the counter antihistamines such as Benadryl. Some antidepressants are also anticholinergic.

Although previous research has discovered a link between anticholinergic medications and dementia among older adults, this is believed to be the first study of those links using neuroimaging measurements of brain metabolism and atrophy.

“These findings provide us with a much better understanding of how this class of drugs may act upon the brain in ways that might raise the risk of cognitive impairment and dementia,” said study author Shannon Risacher, Ph.D., in a press release. “Given all the research evidence, physicians might want to consider alternatives to anticholinergic medications if available when working with their older patients.”

The study’s 451 participants were drawn from a national Alzheimer’s project, and 60 of them were taking at least one medication with medium or high anticholinergic activity. Researchers used PET scans to measure brain metabolism and MRIs to scan brain structure as well as cognitive tests. The cognitive tests showed participants taking the drugs performed worse on short-term memory and some executive function tests. The MRIs showed that people taking the meds had reduced brain volume and larger cavities inside the brain.

“These findings might give us clues to the biological basis for the cognitive problems associated with anticholinergic drugs, but additional studies are needed if we are to truly understand the mechanisms involved,” Dr. Risacher said.