CBT for anxiety or sleep
Buspirone (non-addictive anti-anxiety med)
Mindfulness, meditation, or prescribed SSRIs for chronic anxiety
4. Sleep Aids (Non-Benzodiazepine “Z-Drugs”)
Examples: Zolpidem (Ambien), Eszopiclone (Lunesta), Zaleplon (Sonata)
🔹 Why it’s concerning:
Though marketed as safer than benzos, “Z-drugs” still act on similar brain receptors and are linked to confusion, memory lapses, and increased fall risk. Long-term use is associated with higher dementia incidence.
📌 Safer alternatives: Sleep hygiene, melatonin, or prescription alternatives like suvorexant (Belsomra)
5. Statins (Controversial but Monitored)
Examples: Atorvastatin (Lipitor), Simvastatin (Zocor)
🔹 Why it’s debated:
Statins lower cholesterol, which is vital for heart health — but cholesterol is also essential for brain cell membranes and hormone production. Some patients report brain fog, memory loss, or confusion. While large studies haven’t confirmed a direct dementia link, caution is advised, especially in older adults.
📌 What to do: Discuss risks vs. benefits with your doctor. Monitor cognitive symptoms. Never stop statins without medical advice.
6. Antipsychotics (Especially in Older Adults)
Examples: Risperidone (Risperdal), Quetiapine (Seroquel), Olanzapine (Zyprexa)
🔹 Why it’s concerning:
Often prescribed off-label for agitation in dementia patients, these drugs can actually worsen cognitive decline and increase mortality. The FDA has issued black-box warnings for their use in elderly patients with dementia-related psychosis.
📌 Use only when absolutely necessary, under close supervision.
7. Certain Antidepressants
Examples: Paroxetine (Paxil), Amitriptyline (Elavil) – particularly those with strong anticholinergic effects
🔹 Why it’s concerning:
Some antidepressants double as anticholinergics, increasing dementia risk with prolonged use.
📌 Safer alternatives: SSRIs like sertraline (Zoloft) or escitalopram (Lexapro), which have lower anticholinergic activity.
8. Antihistamines (First-Generation)
Examples: Diphenhydramine (Benadryl), Doxylamine (Unisom SleepTabs)
🔹 Why it’s concerning:
Frequently found in over-the-counter sleep aids and allergy meds, these cross the blood-brain barrier and block acetylcholine — the same mechanism tied to memory problems.
