There are many over-the-counter and prescription medications that can greatly impair memory functioning. Of special note are medications called anticholinergics. These medications are prescribed for other conditions (such as urinary incontinence) and act to inhibit acetylcholine, the neurotransmitter primarily responsible for learning and memory. Older adults are especially vulnerable to the effects of anticholinergic medications. Side effects include: acute confusion, poor attention, disorientation, and short-term memory problems. Remember, a sudden onset of memory impairment (acute confusional state) probably represents a delirium and not a dementia. Toxic effects of medication or illness most commonly cause delirium. If you suspect that you or a loved one is experiencing delirium, get to the hospital immediately.

In general, any medication that has a sedating side effect can impair memory. Shortly we will provide a list of some of these medications. It is a good idea to check with your physician or pharmacist to see if any of the medications that you are on may be affecting your memory.

Another important consideration for healthy memory functioning is sleep. Without proper sleep, it is difficult if not impossible to have a reliable memory. Do you have difficulty falling asleep? Do you wake up several times during the night? Sleep is a complex subject worthy of expert opinion if you think you might be having problems in this area. We recommend that you seek medical advice if you suspect that this is a problem for you. A formal sleep study may help to improve your memory.

Avoid sleep medications if at all possible. Regularly taking medications to help fall asleep may actually be doing more damage than good. Studies have shown that when we rely on prescribed or over-the-counter sleep medications, our bodies have difficulty entering deep or REM (rapid eye movement) sleep. This deep sleep is the stage of sleep that serves to restore your body and provide restful rejuvenation. For every night slept you only cycle into this final stage of sleep for a limited time. Remember, sleep is a linear process and you must first cycle through the three proceeding cycles before entering the stage that provides the essential rest that your body and mind needs. With any break in this process you must start over from stage one. Given enough interruptions within the sleep cycle, you may spend eight hours in bed and rarely enter REM sleep. Are you waking up tired? Improving the quality of your sleep may improve your memory. Consult your doctor about a sleep apnea study.

Medications that have been identified as possibly causing memory impairment (Physician's Drug Reference 2001; Sabiston 1997; Preston et al. 1999): They are listed alphabetically by trade name, but generic names are included in parenthesis. We have also broken down the drugs into broad categories of use (what they are used to treat). Remember, any type of tranquilizer or sleeping pill is probably going to have some direct effect on memory functioning. Also keep in mind that many other drugs can impair memory functioning indirectly by causing other symptoms that eventually lead to memory impairment. Medications that may cause depression, insomnia, or change in glucose levels are examples of such medications. Now let's look at some of the specific medications that have been identified as possibly causing memory impairment. Use the following lists to compare your current medications or new medications that you receive.

Aldactazide (spironolactone) * Aldoril (methyldopa) * Aldomet (methyldopa) * Apresazide (hydralazine) * Blocadren (timolol) * Bumex (bumetanide) * Cartrol (carteolol) * Combipres (clonidine) * Coreg (carvedilol) * Corgard (nadolol) * Corzide (bendroflumethiazide) * Demadex (torsemide) * Diupres (reserpine) * Diuril (chlorothiazide) * Dyazide (triamterene) * Enduronyl (deserpidine) * Enduron (methyclothiazide) * Esidrix (hydrochlorothiazide) * Hydropres (reserpine) * Hygroton (chlorthalidone) * Inderal (propranolol) * Inderide LA (propranolol) * Kerlone (betaxo1ol) * Levatol (penbutolol) * Lopressor (metoprolol) * Lozol (indapamide) * Moduretic (amiloride) * Metahydrin (trichlormethiazide) * Normodyne (labetalol) * Rogroton (reserpine) * Salutensin (reserpine) * Sectral (acebutolol) * Ser-Ap-Es (reserpine) * Tenoretic (atenolol) * Tenormin (atenolol) * Visken (pindolol) * Zaroxolyn (metolazone) * Zebeta (bisoprolol) * Ziac (bisoprolol)

Atarax/Vistaril (hydroxyzine) * Ativan (prazepam) * BuSpar (buspirone) * Butisol Sodium (butabarbital) * Centrax (prazepam) * Compazine (prochlorperazine) * Dalmane (flurazepam) * Doriden (glutethimide) * Halcion (triazolam) * Haldol (haloperidol) * Klonopin (clonazepam) * Librium (chlordiazepoxide) * Luminal Sodium (phenobarbital) * Mellaril (thioridazine) * Miltown (meprobamate) * Navane (thiothixene) * Nembutal (pentobarbital) * Noctec (chloral hydrate) * Noludar (methyprylon) * Prolixin (fluphenazine) * Restoril (temazepam) * Serax (oxazepam) * Stelazine (trifluo perazine) * Thorazine (chlorpromazine) * Tranxene (clorazepate) * Elavil (amitriptyline) * Valium (diazepam) * Xanax (alprazolam)

Axid (nizatidine) * Pepcid (famotidine) * Tagamet (cimetidine) * Zantac (ranitidine)

If you are on one of the above medications and feel that you are having difficulty with your memory, then consult your physician. The medication may be at least partially responsible for your memory difficulties. We all have different tolerance levels to different substances. What might be toxic for you may be an adequate dose for another. It may not be necessary for you to stop taking the medication. A simple adjustment in your prescription may prove to greatly reduce its side effects.

Now we will look at some medications that have been identified as occasionally causing delirium. Delirium usually has a rapid onset and is characterized by severe confusion. One of the leading causes of delirium in older adults is adverse reactions to medications. Following is a list of medications that may cause delirium. Use this list now and in the future to troubleshoot potential difficulties. Again, they are listed in alphabetical order and according to use.

Catapres (clonidine HCI) * Dura-Tabs (quinidine) * Duraquin (quinidine) * Lanoxicaps (digoxin) * Lanoxin (digoxin) * Norpace (disopyramide phosphate) * Tenex (guanfacine HCI)

Chibroxin (norfloxacin) * Ciloxan/Cipro (ciprofloxacin) * Cytovene (ganciclovir) * Levaquin (levofloxacin) * Maxaquin (lomefloxacin) * Ocuflox/Floxin (ofloxacin) * Penetrex (enoxacin) * Raxar (grepafloxacin) * Symmetrel (amantadine HCI) * Urised (methenamine/methylene blue/salol) * Zagam (sparfloxacin) * Zovirax (acyclovir)

Amaryl (glimepiride) * DiaBeta/Micronase (glyburide) * Diabinese (chlorpropamide) * Dymelor (acetohexamide) * Glucotrol (glipizide) * Humalog (insulin lispro) * Orinase (tolbutamide) * Tolinase (tolazamide)

Acthar (corticotropin) * Azmacort (triamcinolone) * Cortef (hydrocortisone) * Cortone Acetate (cortisone) * Decadron/Hexadrol (dexamethasone) * Deltasone/Meticorten (prednisone) * Diprolene/Valisone (betamethasone dipropionate/valerate) * Medrol (methylprednisolone) * Metreton/Pred Forte (prednisolone)

Atarax/Vistaril (hydroxyzine HCI/pamoate) * Benadryl (diphenhydramine) * ChlorTrimeton (chlorpheniramine) * Dimetane (brompheniramine maleate) * Hismanal (astemizole) * Myidil (triprolidine) * Optimine (azatadine maleate) * Periactin (cyproheptadine HCI) * Seldane (terfenadine) * Tavist (clemastine fumarate)

Advil/Motrin (ibuprofen) * Aleve/Naprosyn (naproxen) * Ansaid/Ocufen (flurbiprofen) • Arthropan (choline salicylate) * Ascriptin/Bufferin (aspirin) * Bayer/Ecotrin (aspirin) * Butazolidin (phenylbutazone) * Clinoril (sulindac) * Daypro (oxaprozin) * Disalcid (salsalate) * Doan's Pills (magnesium salicylate) * Dolobid (diflunisal) * Duract (bromfenac) * Feldene (piroxicam) * Indocin (indomethacin) * Lodine (etodolac) * Meclomen (meclofenamate sodium) * Nalfon (fenoprofen calcium) * Orudis (ketoprofen) * Relafen (nabumetone) * Talwin (pentazocine HCI/aspirin) * Tolectin (tolmetin sodium) * Toradol (ketorolac tromethamine) * Trilisate (choline or magnesium salicylate) * Voltaren (diclofenac sodium)

Antivert (meclizine HCI) * Atropine (atropine sulfate) * Axid (nizatidine) * Bentyl (dicyclomine HCI) * Compazine (prochlorperazine) * Ditropan (oxybutynin chloride) * Donnatal (Belladonna Alkaloids /Phenobarbital) * Librax (clidinium/chlordiazepoxide) * Lomotil (diphenoxylate HCI/atropine sulfate) * Pepcid (famotidine) * Phenergan (promethazine HCI * Tagamet (cimetidine) * Tigan (trimethobenzamide HCI * Zantac (ranitidine)

Asendin (amoxapine) * Aventyl/Pamelor (norlriptyline) * Desyrel (trazodone) * Elavil (amitriptyline) * Lithobid/Lithonate (lithium carbonate) * Ludiomil (maprotiline) * Limbitrol (amitriptyline/chlordiazepoxide) * Norpramin (desipramine) * Prozac (fluoxetine) * Sinequan (doxepin HCI) * Tofranil (imipramine) * Triavil (amitriptyline/ perphenazine) * Wellbutrin (bupropion HCI)

Ativan (lorazepam) * BuSpar (buspirone HCI) * Centrax (prazepam) * Dalmane (flurazepam) * Doriden (glutethimide) * Halcion (triazolam) * Librium (chlordiazepoxide) * Miltown/Equanil (meprobamate) * Noctec (chloral hydrate) * Noludar (meyhy prylon) * Restoril (temazepam) * Serax (oxazepam) * Tranxene (clorazepate) * Valium (diazepam) * Vistaril/Atarax (hydroxyzine pamoate)

Butisol (butabarbital) * Luminal/Solfoton (phenobarbital) * Nembutal (pentobarbital)

Clozaril (clozapine) * Haldol (haloperidol) * Mellaril (thioridazine) * Navane (thiothixene) * Prolixin (fluphenazine) * Reglan (metoclopramide) * Stelazine (trifluoperazine) * Thorazine (chlorpromazine) * Triavil (amitriptyline/Perphenazine)

Artane (trihexyphenidyl) * Cogentin (benztropine) * Dilantin (phenytoin sodium) * Klonopin (clonazepam) * Larodopa (levodopa) * Parlodel (bromocriptine mesylate) * Permax (pergolide mesylate) * Sinemet (carbidopa/levodopa)

Amipaque (metrizamide) * Bipenden (akineton) * Anafranil (clomipramine HCI) * Cytosar-U (cytarabine) * Elspar (asparaginase) * Lioresal (baclofen) * Mesoridazine (serentil) * Oxybutin (oxybutin chloride) * Trihexyphenidyl (trihexyphenidyl HCI)

As we grow older we can begin to accumulate many medical complications. Many of these medical conditions can greatly impact your memory. These include diabetes, heart conditions, restrictive airway diseases such as chronic obstructive pulmonary disease (COPD), problems with your kidneys, infections, hormone imbalances, cancer, degenerative eye conditions, vitamin and nutritional deficits (especially vitamin B12), and the buildup of ammonia in your system secondary to liver problems. Changes in your vision and hearing can also effect your memory. The list is endless.

It is essential that you consult your physician on any of these conditions or other conditions that you suspect may be affecting your memory. You should have regular checkups with your physician and not allow yourself to be negligent in keeping an eye on certain bodily systems (for instance, prostrate exam for men, breast exam for women, cancer check if you have had cancer in the past).

Chronic pain is another condition that can greatly influence your memory functioning. When you are in pain, endorphins are released that can interfere with the neurotransmitters that guide memory. With pain, your attention tends to be on the pain and not on your environment.