Some medications can cause confusion, memory problems, or cognitive impairment, especially in older adults. In some cases, long-term use of certain drugs has been associated with an increased risk of dementia, but it’s important to distinguish between:
Temporary cognitive side effects (which may improve when the medication is stopped or adjusted), and
Possible increased dementia risk (where the evidence may be mixed or still under study).
Never stop a prescribed medication without consulting your healthcare professional.
1. Anticholinergic Medications
These block the neurotransmitter acetylcholine, which is important for memory and learning.
Examples:
Diphenhydramine
Oxybutynin
Possible effects:
Memory problems
Confusion
Drowsiness
Difficulty concentrating
Older adults are particularly sensitive to these effects.
2. Benzodiazepines
Used for anxiety, insomnia, and some seizure disorders.
Examples:
Diazepam
Lorazepam
Alprazolam
Possible effects:
Sedation
Impaired memory
Reduced attention
Increased risk of falls
Long-term use has been associated with cognitive decline, though research on dementia risk remains debated.
3. Certain Sleep Medications
Examples:
Zolpidem
Possible effects:
Daytime confusion
Memory lapses
Impaired alertness
Risk is generally higher in older adults.
4. Opioid Pain Medications
Examples:
Morphine
Oxycodone
Possible effects:
Mental clouding
Drowsiness
Confusion
Reduced concentration
These effects are often dose-related.
5. Some Antidepressants with Anticholinergic Effects
Examples:
Amitriptyline
Doxepin
Possible effects:
Memory difficulties
Confusion
Drowsiness
6. Certain Antipsychotic Medications
Examples:
Olanzapine
Quetiapine
Possible effects:
Sedation
Slower thinking
Cognitive impairment
These medications are sometimes necessary despite these risks.
7. Some Anti-Seizure Medications
Examples:
Topiramate
Phenobarbital
Possible effects:
Word-finding difficulties
Memory problems
Slowed thinking
8. Muscle Relaxants
Examples:
Cyclobenzaprine
Possible effects:
Drowsiness
Confusion
Cognitive slowing
Important Warning Signs
Contact a healthcare professional if someone develops:
New confusion
Sudden memory loss
Hallucinations
Major personality changes
Difficulty performing familiar tasks
These symptoms can be caused by medications, but they can also result from infections, strokes, metabolic problems, or neurodegenerative diseases.
Key Takeaway
The strongest concerns for cognitive side effects in older adults are generally with anticholinergic medications, benzodiazepines, and combinations of multiple sedating drugs. However, these medications can be appropriate and beneficial for some people, and any decision about changing them should be made with a qualified clinician who knows the person’s medical history.