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Study Examines Prescribing Patterns of Drug Associated With Cognitive Impairment


Many adults with diabetes and the associated complication of peripheral neuropathy, which can be painful as well as harmful, are often prescribed drugs at doses and for durations that could impose an increased risk of cognitive impairment.

[Image source: Adobe Stock]


This study examined the prescribing patterns of tricyclic antidepressants for diabetic peripheral neuropathy, a painful form of nerve damage. The researchers found that nearly two-thirds of these drugs were prescribed at dosages linked to a higher risk of dementia.

Known for their anticholinergic effects, tricyclic antidepressants have been associated with a 30 to 50 percent increased dementia risk when used long-term in older adults. Given that they block the neurotransmitter acetylcholine this is hardly surprising, as acetylcholine is known to play key roles in learning and memory.

Despite diabetes care guidelines endorsing these drugs for managing neuropathy pain and depression, the study highlights a lack of consideration for the cognitive risks of prolonged use. The researchers observed that patients often used these medications for five to nine years, significantly elevating their risk of dementia.

To mitigate this risk the study proposes “deprescribing” tricyclic antidepressants and exploring alternative approaches that do not impair cognitive function.

To learn about Dr. Rath’s science-based natural approach to the prevention and control of diabetes, see chapter 7 of his classic book, ‘Why Animals Don’t Get Heart Attacks…But People Do’.