If someone in your family is living with dementia, their medication list deserves as much attention as their care routine. Some commonly prescribed drugs (and several available over the counter) can worsen cognitive symptoms, accelerate decline, or raise the long-term risk of dementia in people who don’t yet have a diagnosis.
This guide covers the five main drug classes implicated in worsening dementia, how each one affects the brain, and what to ask your doctor about safer alternatives. It’s written for families and carers – not to replace medical advice, but to help you have a more informed conversation with the clinical team managing your loved one’s care.
Key insights
- Several drug classes – including anticholinergics, benzodiazepines and antipsychotics – can worsen dementia symptoms or accelerate cognitive decline.
- Anticholinergic drugs are among the most widely prescribed medications. They include some antihistamines, bladder medications, and older antidepressants.
- Long-term benzodiazepine use (over six months) is associated with up to an 84% increased risk of developing dementia.
- Antipsychotics carry a heightened fatality risk in people living with dementia and should only be used at minimal doses when necessary.
- Always consult your doctor before stopping or changing any prescribed medication — abrupt changes can cause serious harm.
- Safer alternatives exist for most of the drug classes discussed in this article.
How does dementia progress?
Dementia is not a disease itself but rather a symptom of multiple diseases, of which the most common is Alzheimer’s disease.
The brain is a complex organ that regulates almost every function of the body. Physical changes such as the buildup of proteins, low supply of red blood cells or alpha-synuclein (a protein implicated in Parkinson’s disease) clumps in the brain structure can impair cognitive function, leading to the development and progression of dementia. However, you can slow down dementia with medication.
Stages of dementia:
Dementia is a progressive disease, which means once developed, it never stops advancing and continues to escalate in severity until the patient’s death. Research is currently underway to discover a dementia prevention medication.
The stages of dementia are:
- Mild: This is the initial stage of the disease and is not life-threatening. It involves forgetting stuff related to everyday life. Medication for the early stages of dementia is available.
- Moderate: As the disease progresses, the condition also worsens. The patient may suffer from a continuous state of confusion, and the memory deteriorates even more. Medical management of dementia can greatly improve the quality of life.
- Severe: It is the last stage of dementia, characterised by an inability to perform everyday tasks and communicate effectively. Patients usually need assistive care at this stage. Medication for late-stage dementia includes rivastigmine and donepezil, among others.
Medications associated with the worsening of dementia symptoms:
Now that you have a sound understanding of what dementia is, let’s move forward to what medications can cause dementia. Here’s a list of medications that may cause dementia:
1. Anticholinergic Drugs:
The first on our list is anticholinergic drugs – one of the most commonly cited drug classes in relation to dementia risk.
This class of drugs inhibits the production of acetylcholine, a neurotransmitter that plays a significant role in learning, memory and muscle movement. The link between anticholinergic medications and dementia is well-established.
Alzheimer’s disease and dementia are also associated with acetylcholine deficiency. Administering drugs that further reduce the concentration of this neurotransmitter can be hazardous and may cause the disease to progress more rapidly.
Commonly used Anticholinergic Medications:
- Tricyclic antidepressants
- Sedative antihistamines
- Muscle relaxants
- Some over-the-counter medications
- Certain Parkinson’s medications
Many medicines used in daily life are anticholinergics. If there is a family history of dementia, it is worth reviewing all medications with the prescribing doctor.
Alternative Medication: Alternatives to the drugs mentioned above are commonly available but not always prescribed unless the concern is raised with a doctor. It is important to discuss any dementia history with your doctor so they can review the prescription and consider alternatives.
2. Benzodiazepines:
Benzodiazepines, commonly known as tranquillisers, are used to treat depression, anxiety, muscle disorders, and other associated diseases. Anticholinergic and benzodiazepine medication use and risk of incident dementia are commonly addressed concerns.
This class of drugs boosts the effect of GABA receptors (inhibitory receptors) within the brain, producing a sedative and hypnotic effect.
Numerous research studies have examined whether benzodiazepines are linked to the progression of dementia, and more than half have returned positive results. There are two types:
- Long-Acting Benzodiazepines
- Short-Acting Benzodiazepines
Research found that long-acting benzodiazepines were more likely to increase the risk of dementia than short-acting ones. Duration of use also played a significant role: people using benzodiazepines for more than three months had a 30–32% increased chance of developing dementia, while use beyond six months raised that risk to approximately 84%.
Benzodiazepines medications include:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Lorazepam (Atinav)
Benzodiazepines should be approached with particular caution for anyone living with dementia.
Alternative medication: Benzodiazepines are widely prescribed for insomnia and anxiety. While alternatives may not always be as immediately effective, options do exist. Anxiety can be treated with certain SSRIs, and cognitive behavioural therapy can support sleep without medication. It is important to find the most appropriate option for the individual in consultation with their doctor.
3. Steroids
Steroids are a class of drugs used to treat inflammatory diseases.
Dementia is not always permanent. Reversible dementia – a form that can be reversed once the triggering factor is removed – can be caused by steroids, which may produce insomnia and confusion.
Commonly used steroids:
- Prednisone
- Dexamethasone
- Hydrocortisone
- Betamethasone
Research has shown that people using prednisone in high doses or for prolonged periods were more susceptible to dementia compared to other steroidal medications. However, any corticosteroid used in high doses has the potential to exacerbate dementia.
Alternative Medication: Several alternatives to prednisone are available with similar effects but reduced side effects. It is strictly advised not to change or stop the medicine abruptly without consulting your doctor.
4. Antipsychotics.
Antipsychotics are used to treat psychosis and manage behavioural difficulties in older adults. These drugs exert an inhibitory effect on the dopaminergic pathways in the brain.
In people living with dementia, antipsychotics have the potential to increase the risk of serious harm, including an increased fatality risk. If these drugs are necessary, they should be used at the lowest possible dose.
Antipsychotic medications are divided into two generations:
First-generation:
- Haloperidol
Second-generation:
- Risperidone
- Olanzapine
- Quetiapine
Alternatives should always be considered if the person’s health deteriorates. Behavioural therapy is an effective option for managing some symptoms. Certain SSRIs may also help.
5. Beta-Blockers
Beta-blockers are used to treat high blood pressure, prevent heart attacks, and manage heart rhythm.
The use of beta-blockers is linked to the risk of developing vascular dementia and may decrease the quality of life of people who already have dementia.
Commonly used beta-blockers:
- Atenolol
- Acebutolol
- Metoprolol
- Propranolol
What to do if a family member is using these medications
Many of the medications mentioned above are part of the regular regime for older adults.
It is important not to panic if you recognise a medication in a family member’s routine that falls within one of these drug classes. People who stop their medications abruptly can experience serious problems that may cause further harm. Always consult the doctor and raise your concerns before stopping any prescribed medication. Ask them to review the prescription and explore alternatives.
For over-the-counter medications – particularly anticholinergics such as some sleeping pills – it may be possible to stop without a doctor’s consultation. However, an alternative therapy or approach must be employed. The therapy can be concluded if the person shows symptoms of dementia or if their condition declines, but other measures must be in place.
How do I know my loved one has medication-induced dementia?
Early diagnosis can help manage the condition properly and slow its progression. Someone developing medication-induced dementia may show the following symptoms:
- Difficulty concentrating for sustained periods
- Behavioural changes
- Struggling to remember information from everyday life
- A persistent state of confusion
If these symptoms are overlooked and the medication is not reviewed, the condition may worsen over time. Different medications are used to manage symptoms – for example, donepezil can help manage confusion in some people.
It is important to seek medical assessment if dementia runs in the family or if there are concerns about current medications. Communicate openly with the doctor about any drugs that may be linked to cognitive decline.
Can dementia be prevented?
Dementia affects approximately 50 million people every year across the globe. The risk increases with age; people over 65 are more likely to develop symptoms. While certain lifestyle changes may help reduce the risk, they cannot eliminate it. Genetics also play a significant role – if there is a family history of dementia, the risk is higher, and all necessary precautions should be taken.
While a cure for dementia is yet to be discovered, certain medications to slow its progression are available.
1. Physical activity
Physical activity can help reduce the risk of dementia. It also supports overall circulation and mental wellbeing. Around 25–30 minutes of physical activity every day is considered beneficial.
2. Mental exercises
Keeping the brain active helps reduce the risk of dementia. Activities that challenge the brain include:
- Puzzles
- Board games
- Reading
- Learning a new language
3. Healthy diet
Diet plays a significant role in brain health. Maintaining a diet rich in vitamins, minerals, and other nutrients may help reduce the risk of dementia. A beneficial diet includes:
- Proteins
- Unsaturated healthy fats (omega-3 fatty acids)
- Vitamins
4. Avoid smoking and alcohol
Smoking and drinking alcohol may increase the risk of developing dementia. If either is a concern, rehabilitation therapy and a gradual reduction in consumption can help.
How to care for someone living with dementia
Caring for someone with dementia is not straightforward and may require specialist support. The following options are available:
Care home: Some families are unable to provide full-time care at home due to work or other commitments. Care homes are operational across the UK and provide structured support for people living with dementia.
Live-in carer at home: Many families prefer for their loved one to remain at home. In those cases, it is important to have a thorough understanding of dementia, how it progresses, the behavioural changes that may occur, and the relevant medications. In the later stages of the disease, a person may require round-the-clock support. A live-in carer provides one-to-one dementia care in familiar surroundings – maintaining routine, dignity, and independence in a way that a care home placement often cannot.
At Hometouch, our carers receive specialist dementia training from our clinical team, and every placement is supported by a custom care plan reviewed by a dementia care specialist. If you’d like to understand whether live-in care is the right option for your family, speak to one of our care experts – no pressure, just clear guidance.
Frequently Asked Questions (FAQs):
Are there medications to slow dementia?
While it may not be possible to eliminate the disease, certain medications can slow its progression.
Are there medications to help treat dementia?
Yes, several medicines are prescribed to people living with dementia to help manage symptoms and progression.
Is Alzheimer’s a type of dementia?
Yes. Alzheimer’s is the most common form of dementia and is characterised by memory loss and, in later stages, difficulties with motor function.
Can I stop medications linked to dementia if I see symptoms?
It is strongly advised not to stop any medication without consulting your doctor first. They can help you find alternatives and manage any transition safely.
Are all over-the-counter drugs linked to dementia?
Over-the-counter drugs that fall within the anticholinergic class are the primary concern and, in some cases, can be stopped without a doctor’s consultation. However, an alternative approach must always be in place.
How do I convince someone living with dementia to take their medication?
Calm, clear conversations about why the medication matters for their health can help. If resistance is ongoing, speak to the clinical team – they can advise on approaches that work for the individual.
Is dementia a medical or mental illness?
Dementia is a neurological disorder of the brain rather than a mental illness.
Does taking dementia medication help prolong life?
Taking medication for dementia can help slow the progression of the disease, which may extend quality of life.
What are the main dementia medications?
The most commonly prescribed include donepezil, galantamine, and rivastigmine.
Are there side effects of dementia medication?
Some people occasionally experience nausea, vomiting, or muscle pain. These should be discussed with the prescribing doctor.
How does dementia medication work?
Most dementia medications work by blocking the breakdown of acetylcholine, a neurotransmitter important for memory and cognitive function.
Are bladder control medications linked to dementia?
The majority of bladder control medications are anticholinergic, which is why they appear on the list of drug classes linked to dementia risk.
Is there a link between blood pressure medication and dementia?
Beta-blockers, in particular, have been associated with an increased risk of vascular dementia.
Can you drink alcohol while taking dementia medication?
Drinking alcohol is not recommended alongside dementia medication, as it may interfere with how the medication works.
What is the best anti-anxiety medication for someone living with dementia?
This depends on the individual. Do not self-medicate – consult your doctor to find the option that best suits the person’s needs and existing medication regime.
