Drugs to treat stomach acid are now linked to a significantly higher risk of dementia. The so-called proton pump inhibitors (PPIs), like Nexium and Prevacid, have been shown in a new study to be statistically associated with a new diagnosis of dementia in people who take them longterm.
The records of over 73,000 patients age 75 and older were analyzed, covering a 7-year period. They were all persons who did not have a dementia diagnosis at baseline. It was found that people prescribed PPIs were significantly likely to get diagnosed with dementia than their counterparts not on PPIs.
Here is a full list of the acid-reducing drugs linked to dementia in this study:
- Prilosec (omeprazole)
- Protonix (pantoprazole)
- Prevacid (lansoprazole)
- Nexium (esomeprazole)
- AcipHex (rabeprazole)
PPIs are generally approved by the FDA to be used for a maximum of 8 weeks to temporarily curb the stomach’s production of acid while healing from inflammation (gastritis), or during treatment for a bacterial infection causing reflux, or while healing from an ulcer. They are also commonly prescribed preventatively to persons at risk for an ulcer (for instance, those on blood thinners or arthritis medications).
Most of these drugs had only been formally studied for a maximum of merely 6 months, and rarely for up to 12 months. Despite the lack of longterm safety data, doctors typically keep patients on renewing prescriptions for the meds for year after a year. TV ads featuring obese people eating fried chicken and hotdogs imply that the regular use of proton pump inhibitors can allow one to get away with such a lousy diet. The advertising must be working: PPIs generate more than $14 billion in annual sales. This class of drugs is one of the most common inappropriate, excessive and unneeded prescriptions.
Alzheimer’s dementia is common and getting even more common, and the wide and longterm use of PPIs may be partly why. There are four FDA-approved drugs for dementia treatment, although they have poor effectiveness and do not cure, reverse or stop progression of the disease in the least. Alzheimer’s is associated with abnormal plaques (hard accumulations) in the brain consisting of a protein called amyloid-beta. There is also an increased amount of circulating and loose amyloid-beta in persons with dementia.
More than 5 years ago a study on mice shed light on just how the PPIs could cause dementia. Frist of all, it is known that drugs like Prevacid (lansoprazole) can cross the blood/brain barrier. When mouse brains were exposed to PPIs in concentrations similar to what a human would be taking, there was significant increase in the amount of amyloid-beta production, up to 250% more than in those not exposed.
The current package inserts for Nexium mentions these mental side effects, but not dementia: apathy, confusion, aggression, hallucination, depression, dizziness, lack of feeling, nervousness, impotence, insomnia, migraine, tremor, dizziness, sleepiness, and numbness.
The package insert for Prevacid likewise does not mention dementia, but warns about drug-induced mental effects including thinking abnormality, emotional instability, hallucinations, hostility, nervousness, neurosis, abnormal dreams, agitation, amnesia, anxiety, apathy, confusion, convulsion, dementia, depersonalization, depression, dizziness, and agitation.
PPIs have previously been found to be associated with another major risk: a joint study by Houston Methodist and Stanford University in 2015 found that regular use of PPIs was associated with a 16% excess risk for heart attack, and double the risk of dying from heart disease compared to persons not on PPIs. Most significantly, the increased risk was not associated with use of blood thinners like clopidogrel (Plavix and others) or with high-risk age groups. In other words, the increase heart attacks and deaths were due to the PPI use alone.
Action item for the smart consumer: Speak with your doctor about coming off of your PPI and seek alternatives for reflux, including apple cider vinegar and natural digestive aids. Read about medical drugs causing mental effects in No-Nonsense Guide to Psychiatric Drugs by Moira Dolan, MD.