Narcotic painkillers
Why they are prescribed: Also called opioid analgesics, these medications are used
to relieve moderate to severe chronic pain, such as the pain caused by
rheumatoid arthritis.
Examples: Fentanyl
(Duragesic), hydrocodone (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo),
morphine (Astramorph, Avinza) and oxycodone (OxyContin, Percocet). These drugs
come in many different forms, including tablets, solutions for injection,
transdermal patches and suppositories.
How they can cause memory loss: These drugs work by stemming the flow of pain signals
within the central nervous system and by blunting one's emotional reaction to
pain. Both these actions are mediated by chemical messengers that are also
involved in many aspects of cognition. So use of these drugs can interfere with
long- and short-term memory, especially when used for extended periods of time.
Alternatives: In
patients under the age of 50 years, nonsteroidal
anti-inflammatory drugs (NSAIDs) are the frontline therapy for
pain. Unfortunately, NSAID therapy is less appropriate for older patients, who
have a much higher risk of dangerous gastrointestinal bleeding. Research shows
the risk goes up with the dosage and duration of treatment.
Talk with your doctor or other health care provider about
whether tramadol (Ultram), a nonnarcotic painkiller, might be a good choice for
you. In my practice, I often recommend supplementing each 50 mg dose with a 325
mg tablet of acetaminophen (Tylenol). While there are prescription drugs that
combine tramadol and acetaminophen, these products have only 37.5 mg of
tramadol, and in my practice I've found that patients generally need the larger
dose.
Antidepressant drugs (Tricyclic
antidepressants)
Why they are prescribed: TCAs are prescribed for depression and, increasingly,
anxiety disorders, eating disorders, obsessive-compulsive disorder, chronic
pain, smoking cessation and some hormone-mediated disorders, such as severe
menstrual cramps and hot flashes.
Examples: Amitriptyline
(Elavil), clomipramine (Anafranil), desipramine (Norpramin), doxepin
(Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline
(Vivactil) and trimipramine (Surmontil).
How they can cause memory loss: About 35 percent of adults taking TCAs report some degree
of memory impairment and about 54 percent report having difficulty
concentrating. TCAs are thought to cause memory problems by blocking the action
of serotonin and norepinephrine — two of the brain's key chemical messengers.
Alternatives: Talk
with your health care provider about whether nondrug therapies might work just
as well or better for you than a drug. You might also want to explore lowering
your dose (the side effects of antidepressants are often dose-related) or switching to
a selective serotonin/norepinephrine reuptake inhibitor (SSRI/SNRI). Of
the drugs in this category, I find venlafaxine (Effexor) to have the fewest
adverse side effects in older patients.
MAYBE THIS IS WHY YOU CAN'T REMEMBER NAMES !!!
MORE TO COME !!!!!!
Dr Phillip Paulk
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