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Drug-Induced Dementia and Delirium Common in Seniors But Often Undetected, Public Citizen Says

Condition Is Usually Reversible, Can Be Caused by 136 Drugs Listed on

WASHINGTON - Older patients become more susceptible to drug-induced dementia and
delirium as they age, but the symptoms are often overlooked by doctors
who don't realize that the condition may be caused by drugs and
reversed, Public Citizen writes in a Worst Pills, Best Pills News article released today on, the organization's drug safety Web site.

Unlike most forms of dementia, such as Alzheimer's disease, which
cannot be reversed, dementia caused by prescription drug use may be
stopped by discontinuing the offending medication. The drug safety
experts at Public Citizen have identified 136 commonly prescribed
medications, especially certain antidepressants and pain medications,
that can cause difficulty thinking.

Drug-induced dementia and delirium are commonly misattributed to
underlying medical illness or merely to "old age." But by stopping or
modifying the dosage of numerous, frequently prescribed drugs, most
patients can be restored to a pre-drug state of mental clarity.

Older people are more susceptible to drug-induced delirium and
dementia because the body's ability to rid itself of drugs decreases
with age, often because of normal age-related decrease in kidney and
liver function. Also, older patients are often prescribed multiple
drugs at the same time, resulting in complicated interactions and
enhanced side effects. Some research also suggests older patients'
brains may be more sensitive to drugs' effects on the central nervous

"Sadly, doctors don't always recognize cognitive impairment as a
side effect, so many patients needlessly suffer from this debilitating
but reversible condition," said Sidney Wolfe, M.D., director of Public
Citizen's Health Research Group and acting Public Citizen president.
"After beginning new drugs, doctors, patients and their families should
watch for subtle changes in cognition and assume changes may be caused
by drug therapy. People already suffering from some cognitive
impairment are most susceptible."

Delirium is a syndrome of changes in vision, hearing and thinking
that usually starts abruptly and is commonly seen in the hospital
setting or during an acute illness; symptoms typically improve when the
cause is treated. Dementia, on the other hand, is a chronic alteration
in thinking that progresses slowly. Alzheimer's disease is dementia's
most common cause, but it also can be caused by strokes and other
conditions. includes the
full list of 136 implicated drugs. Some examples include: widely used
antihistamines such as diphenhydramine (Benedryl); a drug widely used
for treating urinary incontinence, tolteridine (Detrol); a nausea
treatment drug, metoclopramide (Reglan); and drugs in the
benzodiazepine category such as popular sleeping pills Ambien
(zolpidem) and Lunesta (eszopiclone).

Worst Pills, Best Pills News is a monthly newsletter available in print and electronic formats through Public Citizen's subscription Web site, . The article about drug-induced dementia and delirium will be available free for the next seven days. The site has other searchable information about the uses, risks and side effects associated with prescription medications. is an
unbiased analysis of information from a variety of sources, including
well-regarded medical journals and unpublished data obtained from the
Food and Drug Administration, that allows Public Citizen to sound the
alarm about potentially dangerous drugs long before they are banned by
the federal government and to recommend safer drugs. For example,
Public Citizen warned consumers about the dangers of Vioxx, ephedra,
Baycol and Propulsid years before they were pulled from the market.


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Public Citizen is a national, nonprofit consumer advocacy organization founded in 1971 to represent consumer interests in Congress, the executive branch and the courts.

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