Caution! These Drugs Can Cause Memory Loss

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.

Alternatives: 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. You can also talk with your health care provider about whether nondrug therapies might work just as well or better for you than a drug.

4. Narcotic painkillers (opioids)

Why they are prescribed: These medications are sometimes used to relieve moderate to severe pain from surgery or injuries. In some instances, they can also be used to treat chronic pain.

Examples: Fentanyl (available as a patch), hydrocodone (Vicodin), hydromorphone (Dilaudid, Exalgo), morphine and oxycodone (Oxycontin). These drugs come in many different forms, including tablets, solutions for injection, transdermal patches and suppositories.

How they can affect memory: These drugs work by stemming the flow of pain signals within the central nervous system and by blunting one’s emotional reaction to pain. Both these actions are mediated by chemical messengers that are also involved in many aspects of cognition, so use of these drugs can interfere with long- and short-term memory, especially when used for extended periods of time. Researchers have also found a link between opioid use and dementia in older adults.

Alternatives: In patients under the age of 50 years, nonsteroidal anti-inflammatory drugs (NSAIDs) are the frontline therapy for pain. Unfortunately, NSAID therapy is less appropriate for older patients, who have a much higher risk of gastrointestinal bleeding. Research shows the risk goes up with the dosage and duration of treatment.

Talk with your doctor or other health care provider about whether tramadol, a nonnarcotic painkiller, might be a good choice for you. Acetaminophen (Tylenol) may be another option, but again, it’s important to consult your doctor about risks, side effects and drug interactions for all medications.

5. Sleeping aids (nonbenzodiazepine sedative-hypnotics)

Why they are prescribed: Sometimes called the “Z” drugs, these medications can be used to treat insomnia and other sleep problems. They also are prescribed for mild anxiety.

Examples: Eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien).

How they can affect memory: Although these are molecularly distinct from benzodiazepines (see No. 1 above), they act on many of the same brain pathways and chemical messengers, producing similar side effects and problems with addiction and withdrawal. The “Z” drugs also can cause amnesia and sometimes trigger dangerous or strange behaviors, such as cooking a meal or driving a car with no recollection of the event upon awakening.

Alternatives: There are alternative drug and nondrug treatments for insomnia and anxiety, so talk with your health care professional about options. Melatonin, for instance, can help to reestablish healthy sleep patterns. And cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for the sleep disorder.

Before stopping or reducing the dosage of these sleeping aids, be sure to consult your health care provider. Sudden withdrawal can cause serious side effects, so a health professional should always monitor the process.

6. Incontinence drugs (anticholinergics)

Why they are prescribed: These medications are used to relieve symptoms of overactive bladder and reduce episodes of urge incontinence, an urge to urinate so sudden and strong that you often can’t get to a bathroom in time.

Examples: Darifenacin (Enablex), oxybutynin (Ditropan XL), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). Another oxybutynin product, Oxytrol for Women, is sold over the counter.

How they can affect memory: These drugs block the action of acetylcholine, a chemical messenger that mediates all sorts of functions in the body. In the bladder, anticholinergics prevent involuntary contractions of the muscles that control urine flow. In the brain, they inhibit activity in the memory and learning centers. The risk of memory loss is heightened when the drugs are taken for more than a short time or used with other anticholinergic drugs.

Older adults are particularly vulnerable to the other adverse effects of anticholinergic drugs, including constipation (which, in turn, can cause urinary incontinence), blurred vision, dizziness, anxiety, depression and hallucinations.

Alternatives: As a first step, it’s important to make sure that you have been properly diagnosed. Check with your doctor or other health professional to see if your urinary incontinence symptoms might stem from another condition (such as a bladder infection or another form of incontinence) or a medication (such as a blood pressure drug, diuretic or muscle relaxant).

Once these are ruled out, try some simple lifestyle changes, such as cutting back on caffeinated and alcoholic beverages, drinking less before bedtime, and doing exercises to strengthen the pelvic muscles that help control urination.

Some urologists are treating overactive bladder with Botox injections to help the muscle relax. Solutions beyond the medicine aisle can also come in handy. “I’ve been really thrilled with the improvements in protective [undergarment] items. They’ve really come a long way,” says K. Ashley Garling-Nañez, clinical assistant professor at the University of Texas at Austin College of Pharmacy. “There are a lot more options for active adults.”

7. Antihistamines (first generation)

Why they are prescribed: These medications are used to relieve or prevent allergy symptoms or symptoms of the common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting and dizziness, and to treat anxiety or insomnia.

Examples: Brompheniramine (Dimetane), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl) and hydroxyzine (Vistaril).

How they can affect memory: These medications (prescription and over-the-counter) inhibit the action of acetylcholine, a chemical messenger that mediates a wide range of functions in the body. In the brain, they inhibit activity in the memory and learning centers.

Alternatives: Newer-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are better tolerated by older patients and do not present the same risks to memory and cognition.

Other medications worth noting

Corticosteroids. These anti-inflammatory drugs, which are used to treat rheumatoid arthritis, lupus and other conditions, can cause confusion and memory loss in patients on high doses, Devanand says. They can also trigger depression.

Heartburn medications. Some recent studies, including one from 2022 published in BMC Medicine, have found a link between medications commonly used to treat gastroesophageal reflux disease (GERD), heartburn and peptic ulcers with an increased risk of dementia. If you take an over-the-counter proton-pump inhibitor, Garling-Nañez says it’s important to use the medication in moderation and for short amounts of time. “Anything over the counter, try not to use it for more than two weeks at a time, is typically what we recommend,” she says.

Cannabinoids. Access to cannabis, and use of the drug, has grown in recent years. Mounting research shows that cannabis may have an effect on our cognition. A study published in The American Journal of Psychiatry in March 2022 followed approximately 1,000 individuals and found that long-term cannabis users showed cognitive deficits, as well as memory and attention problems. Another study from 2020 found cannabis use was associated with deficits in executive function, learning and memory.

Check your numbers

The number of drugs you’re taking could be affecting your memory, as well. Taking multiple medications — a practice known as polypharmacy — has been linked to lower memory function in older adults, as well as an increased risk for delirium.

A report from the Lown Institute shows that 42 percent of older adults take five or more prescription medications. If you’re concerned about the number of pills crammed into your pillbox, Garling-Nañez suggests asking your doctor if every single one of them is still necessary, or if there are any you can stop taking. If you do stop taking medication, just be sure to do so under the supervision of your doctor. “Some have to be tapered off; you can’t just go off them cold turkey,” she adds.

Editor’s note: This story, originally published Feb. 9, 2016, has been updated to include new information. Rachel Nania contributed additional reporting to this update.