8.06.2007

H2 Blockers and Mental Decline

This story from WebMD is interesting - a correlation of those taking H2 acid blockers and dementia.

According to Indiana University researcher Malaz Boustani, MD, MPH, and colleagues. "Patients had two to two-and-a-half times the odds of having a deficit in their cognitive performance [if they took over the counter H2 blockers]. It ranged from mild to potentially severe dementia similar to Alzheimer's disease."

Boustani, a gerontologist, noticed that his elderly patients sometimes appeared confused after taking over-the-counter H2 blockers.

He's not the first to notice this. Histamine-blocking drugs such as some kinds of antihistamines or H2 blockers often contribute to mental confusion, says neurologist Charles J. Duffy, MD, PhD, director of cognitive and behavioral neurology at the University of Rochester, N.Y. Duffy was not involved in the Boustani study.

"We have known for some time that H2 blockers have an impact on cognitive capacity and can contribute significantly [as one of many factors] in delirium -- particularly in the elderly or in those with brain pathology," Duffy tells WebMD.

Lately I've started to wonder about polypharmacy and the unintended effect of a pill for every ill. In the hospital, my 90+ year olds always seem healthier and mentally more sharp than my 70 and 80 year olds. This could of course be social -- the younger group having drank more alcohol and smoked more cigerettes -- but my 90+ patients also seem to have one other thing in common. They all avoid doctors and at most take a daily aspirin.

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