The 7 common NHS drugs that raise dementia risk – as docs ‘prescribing meds to millions without warning them’

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MILLIONS of Brits are being prescribed medications without being told that they may raise the risk of dementia, a shock investigation has revealed.

NHS figures show that more than four million people over the age of 65 take at least one of a class of drugs known as anticholinergics.

These are medicines that block acetylcholine, a vital chemical that helps brain and muscle cells communicate with each other.

Common examples of anticholinergic drugs include oxybutynin and tolterodine for overactive bladder and incontinence, benztropine and trihexyphenidyl for Parkinson’s disease symptoms and amitriptyline for depression.

But, studies have shown that taking such drugs may contribute to an increased risk of developing dementia later in life.

All drugs are issued with patient information leaflets that include warnings about possible side-effects.

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She added: “We can’t wait for more evidence to build up because millions more people will take these medicines over the next few decades.”

One of the most recent studies on the link between the drugs and dementia was published in 2023.

The research, led by scientists at the University of Nottingham, showed those who took bladder anticholinergics such as oxybutynin were 18 per cent more likely to develop dementia than those who did not.

One of the authors, Tony Avery, is now NHS England’s national clinical director for prescribing.

In 2020, when he was a professor of primary health care at the University of Nottingham, he warned that “we should act now and advise colleagues not to use anticholinergics associated with dementia for bladder symptoms when there are alternatives that appear to be safer”.

Another study, published in the British Medical Journal in 2018, found that people diagnosed with dementia were up to 30 per cent more likely to have been prescribed anticholinergic medications for Parkinson’s, bladder problems, or depression.

However, there was no association between dementia and anticholinergic drugs used to treat other common conditions like hay fever, travel sickness, and stomach cramps.

The research also found that people who developed dementia took the anticholinergic medication for between four and 20 years before being diagnosed, and the longer they took the drugs, the greater their risk.

UK drugs watchdog, the Medicines and Healthcare Products Regulatory Agency (MHRA), reviewed the dementia risk posed by bladder anticholinergics earlier this year.

However, it concluded that the dementia risk could not be ruled out but said the current evidence was not strong enough to require action.

Which 7 anticholinergic drugs have been linked to dementia?

Research has suggested there may be a link between seven frequently prescribed anticholinergic drugs.

They are often used to treat conditions such as Parkinson’s, incontinence and depression.

These specifically include:

Procyclidine (Kemadrin) for Parkinson’s
Tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions like overactive bladder or incontinence
Amitriptyline, dosulepin, and paroxetine for depression

Source: The British Medical Journal

The National Institute for Health and Care Excellence (Nice), which sets clinical guidelines for NHS care, has said the anticholinergic burden should be actively minimised and reviewed by doctors, particularly among older patients.

It comes as an analysis of NHS figures earlier this month also found that at least 1,000 elderly Britons are admitted to A&E every day suffering preventable reactions to the cocktail of drugs they’ve been prescribed.

The number of emergency admissions has risen by 40 per cent in eight years, figures showed.

Roughly eight million people in the UK are also at risk of side effects because they are being prescribed five or more drugs to take daily.

Taking more than five medicines is defined as “polypharmacy”, when the risk of dangerous side-effects increases.

It is particularly dangerous in more frail patients and in some cases, could even be fatal.

Alison Cave, the chief safety officer at the MHRA, said: “It is already known that taking more than one anticholinergic medicine increases the risk of experiencing side-effects, so these medicines should be limited where possible in older adults.

“Patients should continue taking their medicines as prescribed and if they have any concerns, they should discuss these with their healthcare professional.”

An NHS spokesman said: “Anticholinergic drugs must always be prescribed in line with clinical guidance and with the patient’s or carer’s agreement, following a discussion to ensure the risks and benefits are fully considered and understood.

“The NHS is committed to stopping medications from being prescribed when no longer necessary and carried out 3.6 million medication reviews last year to ensure people living with frailty were only prescribed the medication they really needed; and with thousands of pharmacists working in GP practices, we expect this number to increase.”