Mental Health Drugs That Cause Memory Loss
Memory loss is a common topic within the mental health world.
I’m going to summarize some research on which mental health medications impact our memory and why they do.
Memory refers to the mechanisms that are used to collect, accumulate, preserve, and later retrieve information.
Mental Health Drugs That Cause Memory Loss
Selective Serotonin Reuptake Inhibitors | SSRIs
citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd
This is a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain.
Over 10% of the US takes an SSRI.
What Do SSRIs Do?
What does every medication within this class have in common?
They all increase the level of Serotonin in your brain. Serotonin is a neurotransmitter. When you take a Serotonin Reuptake Inhibitor, you’re blocking the neurons from reabsorbing Serotonin, meaning there is more Serotonin available.
So what does Serotonin do?
Well, A LOT.
Serotonin influences our mood and emotional state, our digestion, appetite, our sleep cycle.
It is found in your brain, in your intestines and even in your blood.
One could argue that it impacts everything.
Did You Know?
Serotonin is even in animals, plants and fungus.
How SSRIs Impact Memory
Research has shown that SSRIs are correlated with memory loss, but that doesn’t exactly mean that they CAUSE it. Correlation and cause are two different things.
Many people that take SSRIs also take benzodiazepines, drink, smoke, have genetic predisposition to memory loss, etc.
Depression and anxiety themselves can even cause memory problems.
So, after reading through many articles, there overall wasn’t enough credible information to emphatically say that an SSRI causes memory loss.
Therefore, any medication listed as an SSRI has not been proven to be one of the mental health drugs that cause memory loss.
In fact, I came across more research that suggested SSRIs improve cognitive performance and memory.
Some data also specifically supported that SSRI’s can improve memory for patients experiencing psychosis and depression.
Tricyclic Antidepressant | TCAs
anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class.
These existed before SSRIs, but they seem to cause more side effects.
This has led to SSRIs being more commonly prescribed nowadays.
TCAs are still often administered for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.
What do Tricyclic Antidepressants Do?
What do all TCAs have in common?
Similar to an SSRI, tricyclic antidepressants impact neurotransmitters. But, in addition to serotonin, they also block the reabsorption of norepinephrine. They ALSO block acetylcholine receptors.
These key differences create a cascade of effects in the body that do impact memory.
These key differences are also the culprit for the common side effects in this drug class like dry mouth, blurred vision, and urinary retention.
Did You Know?
In 1945, the Sulphur bridge of the phenothiazine ring of promethazine was altered to synthesize G22355 (a weak antihistamine and mild anticholinergic with sedative properties).
The new ‘invention’ was tested as an antipsychotic.
It was ineffective for schizophrenia, but did have antidepressant properties.
Thus, the first clinically useful tricyclic antidepressant (TCA) was discovered.
How TCAs Impact Memory
There are multiple reasons why a TCA impacts our memory.
The first reason is that we retain memory best when norepinephrine is released at an optimal rate.
These drugs block the reabsorption of norepinephrine; which is known to be a moderator of memory.
With too much of it, we are anxious and stressed, too little of it and we are drowsy and not as coherent.
Either way, the drug has an impact on norepinephrine which directly influences how we store memory.
The second reason why this drug class impacts memory is because it competes with our natural antagonists on muscarinic, and histaminergic receptors.
It is well documented that these drugs block muscarinic receptors (which is an acetylcholine receptor), and acetylcholine directly impacts learning and memory.
“Muscarinic acetylcholine receptors in the hippocampus and cortex underlie memory formation”
So, TCAs are a drug that research has linked with memory impairments and dementia.
Any medication within the TCA drug class is potentially one of the mental health drugs that cause memory loss.
These drugs interfere with our bodies baseline of norepinephrine and acetylcholine.
As with any drug; sometimes they create an optimal effect on a person, as for others, not so much.
If a person is too excitable and anxious, a TCA can improve their quality of life (even could improve memory if their extreme anxiety was impairing it), while for another it can make them drowsy and leave a bad impression.
*Note each drug within the class impacts the degree of these effects a little differently.
If you’re feeling like doing a deep dive into some of the articles I read to gain clarity, by all means, click the links below!
alprazolam, xanax, chlordiazepoxide, librium, clonazepam, klonopin, clorazepate, tranxene, diazepam, valium, lorazepam, ativan, oxazepam, serax, temazepam, restoril, triazolam, halcion
These are commonly considered anti-anxiety medication (though can be used for seizures, insomnia, and muscle spasms).
They work by quickly slowing down important parts of our brain.
Let’s taco ‘bout it.
This drug class specifically targets the GABA-A receptor, enhancing its effect, which slows down our central nervous system; this makes us feel relaxed, because the drug has retarted a major gear in our system (sometimes this is EXACTLY what we need).
Did You Know?
Anesthesiologists often give Versed (a benzodiazepine) so patients will not remember surgery?
How Benzodiazepines Impact Memory
This drug class changes our mental state & while the drug is advantageously quick acting, the effects linger.
Short-term memory is not as affected, but long-term memory is specifically impaired.
The memory loss may occur because events are not transferred from short-term memory to long-term memory and thus not consolidated into memory storage.
Therefore any Benzodiazapine, is one of the mental health drugs that can cause memory loss.
The effects are similar to the long-term effects of alcoholism (alcohol is also a CNS depressant).
Both of these substances, used long term actually damage our brain.
This is why a rehab center isn’t going to allow the use of ‘said drug’ while ‘recovering’.
This is why therapists often (but not always) stray away from patients taking ‘said drug’ while trying to work on trauma, recovery, etc.
If the brain is not functioning & you’re not able to remember anything, how can you work on it?
The most effective aspects of benzodiazepines are precisely why individuals have a tendency to become dependent on them.
Now, don’t shoot the messenger. Obviously, there is a time and a place for benzodiazepines.
They’re an actual life saver for the (hopefully) occasional panic attack.
But how sadistic is that Benzodiazepines have addictive properties, which means that with repeated use we will need increasingly higher doses, making the dent in your memory more and more indisputable.
Do you know an addict whose drug of choice is a benzodiazepine?
No SHAME, but if so, you can probably attest that they don’t remember sh*t.
How about an addict whose drug of choice is alcohol?
All love here, but you can say for certain, they don’t remember sh*t.
There has even been a fair amount of data to support that the risk of Alzheimer’s is elevated in those taking the drug for over 6 months.
One Harvard study even speculated that it would raise the risk by 84%!
Seems unrealistic, but who am I to question Harvard; I’ll add the link below if you’re also feeling speculative.
Another point of concern is that this drug will inhibit your brain from initiating activity of GABA A (since the medication has so kindly been doing it).
What this means is that after the drug is long gone from your system, your brain experiences a lag in restoring the normal GABA balance.
This is often what is referred to as “rebound anxiety” because your anxiety is likely to get worse, before it gets better after taking a benzodiazepine, especially if taken long term.
Take it from a nurse who works in mental health; it’s not enjoyable being the bystander of a patient trying to escape their benzo addiction.
But this is why the mental health world is increasingly trying to move towards low dosing and only prescribing for a limited amount of time.
Now, Benzodiazepines are very dangerous to quit cold turkey, so please don’t go flush yours down the toilet after reading this.
When Benzodiazepines were first discovered they offered an immediate solution to the overwhelming crippling anxiety that many people face, but the harsh reality is that we’re now in a benzo addiction crisis.
We’re learning over time, as a society and those changes don’t happen overnight.
And trust me, as a mental health professional I myself occasionally grow infuriated at the amount of family doctors who prescribe copious amounts of benzodiazepines only to later turn the patient away after addiction has crippled them.
“Right now I’m having amnesia and déjà vu at the same time. I think I’ve forgotten this before.”
topiramate, topamax, zonisamide, zonegran, levetiracetam, keppra, pregabalin, lyrica, clonazepam, klonopin, rufinamide, banzel, vigabatrin, sabril, phenytoin, dilantin, oxcarbazepine, trileptal, carbamazepine, tegretol, lamotrigine, lamictal, lacosamide, vimpat, valproic acid, depakote, phenobarbital, gabapentin, neurontin
Anti-seizure medications are commonly used for mood disorders and even anxiety in addition to epilepsy.
What Do They Do?
Epilepsy is caused by excessive hyperexcitability of the nervous system therefore, medications in this class are geared toward minimizing excitability.
This drug class actually encompasses three different major classes
- Blocking Sodium Channels
- Enhancement of GABA Inhibition
- Regulation of Synaptic Releases
Why it Impacts Memory
Overall, anticonvulsants work in different ways; trust me I rode the magic school for HOURS trying to gain an understanding of them to write this.
Truthfully, we still have a lot to learn about them. Their impact is complicated and the effects range based on the dose and drug.
For instance, Topamax has pretty diverse pharmacologic actions, because of that, it has been linked with impaired concentration, cognitive dulling, psychomotor retardation, language and comprehension difficulties, rather extreme effects on short-term memory and working memory, poor verbal fluency and word-finding, reduced IQ scores, abnormal thinking and delayed cognitive speed.
Because of this dark cloud of side effects, Topamax is sometimes referred to as ‘Dope-A-Max’.
However, a more selective medication within the drug class such as Phenytoin or Tegretol are more specific to blocking sodium channels.
Overall, they seem to have less impact on memory and cognitive function.
Many of these drugs listed above have an impact on GABA, and long term exposure to GABA agents can alter the functionality of GABA permanently, which means there are potentially permanent consequences to cognition, behaviors, and memory.
Phenobarbital has been linked to lower IQ, and worse effects than Depakote and Tegretol, however it is actually a barbituate. It’s effects are similar to benzodiazepines which you can read more about above.
Gabapentin, used for seizures and often mood disorders, belongs to it’s own drug class. Still, it has been linked to memory impairment.
Hence, the name, it also impacts GABA, which as mentioned several times now, certainly plays a hand in our ability to remember.
At this point there isn’t enough research to say it’s linked to dementia though.
As far as drugs for epilepsy, Gabapentin is tolerated much better than many others.
It’s also worth mentioning that this drug seems to have more short term effects on memory.
Some will experience a disorienting feeling or short term memory loss while taking Gabapentin, but the reports of long term memory being impacted are reported less often.
To summarize, a medication within the anti-epileptic drug class is potentially one of the mental health drugs that cause memory loss.
sometimes referred to as major tranquilizers or neuroleptics; risperidone, risperdal, quetiapine, seroquel, olanzapine, zyprexa, ziprasidone, zeldox, paliperidone, invega, aripiprazole, abilify, clozapine, clozaril, fluphenazine
Commonly used as the first line treatment for schizophrenia & sometimes used for mood disorders, depression, personality disorders, Tourette’s syndrome & Huntington’s disease
What Do They Do?
Most drugs in this class work to block Dopamine, though some do impact other chemicals in the brain.
Did You Know?
Oddly enough, memory seems to actually be improved when using an antipsychotic for a person with psychotic symptoms, though there are many that take medications within this class that are not psychotic.
So let’s talk about that more.
Why It Impacts Memory
First, let’s skip back to the purpose of these drugs.
Schizophrenia is the major psychotic disorder we use antipsychotics for.
Some of the main symptoms are delusions, lack of motivation, unusual behaviors, and hallucinations.
Dopamine has been thought to regulate our brains understanding of our surroundings and what it all means to us.
So, it’s to be expected that drugs within this class target Dopamine.
This class is broken up into two categories;
First Generation (old, typical): Block Dopamine-2 Receptors, which means they also block acetylcholine, histamine and norepinephrine. which do impact the complex way in which we store memories. *More movement disorders come with the old ones.
Second Generation: (new, atypical): Block Serotonin and Dopamine Receptors. Less risk of extra movements, increased risk of diabetes, high cholesterol, and weight gain.
What do they all have in common?
They impact Dopamine. Long story short; A delicate balance of Dopamine is needed for memory to function.
Since this class targets Dopamine, it’s fair to say it has the potential to alter our memory.
Whether that’s a good or bad thing is specific to the patient, but it’s typically an unwelcome effect.
To summarize, a medication within the anti-psychotic drug class is potentially one of the mental health drugs that cause memory loss.
A person without psychotic symptoms is more likely to be impacted, while a person with psychotic symptoms may actually experience an improvement in memory.
brompheniramine, dimetane, benadryl, diphenhydramine, carbinoxamine, clistin, clemastine, tavist, doxylamine, unisom, hydroxyzine, atarax, vistaril, promethazine, phenergan, triprolidine, triafed
Commonly used for allergies but also used for anxiety. Antihistamines are divided into different ‘generations’ & target different histamine receptors in our body.
- H1 Receptors: Found Throughout the Body
- H2 Receptors: Mostly Stomach Acid Secretion
- H3 Receptors: Central Nervous System
- H4 Receptors: Still Being Researched
What Do They Do?
We’re still learning a lot about histamines but what we do know is that anti-histamines are usually anticholinergic; blocking receptors for choline.
The problem is that we need choline to be readily available to have the ability to learn, understand and remember.
Why it Impacts Memory?
Being that antihistamines are often anticholinergic, they do impair our ability to think, learn and remember.
Especially the first generation antihistamines that easily penetrate our brain.
We already naturally produce less acetylcholine overtime.
This is partly why as we age our ability to remember, think, and learn diminishes.
It’s widely known that anticholinergics impact memory, thinking, learning, and muscle function.
It is also suggested that these drugs increase the risk of developing dementia.
Did you know?
The only drug within this class that can be given intravenously is Benadryl. Since Benadryl is a first generation, it impacts our body in many ways in addition to the reason why it’s administered.
Since first generation antihistamines are much less specific in their effects, they are affiliated with greater memory impairment.
Though, being the only IV antihistamine available, it is still widely used in hospital settings.
Overall, the effects range.
Regarding mental health specifically; Vistaril, hydroxyzine and Atarax are commonly prescribed for anxiety. While your risks are much less severe than benzodiazepines, these are FIRST generation antihistamines.
Therefore, they do have a sedating effect (precisely why they can relieve tension) but this is also means they do impair our ability to remember.
An example of second generation antihistamines are Claritin & Zyrtec. Unlike first generation antihistamines, these do not cross the blood-brain barrier as easily.
Therefore, they relieve many effects of allergies, but do not have as many sedating properties or memory impairments associated with them.
When it comes to anxiety though, Claritin & Zyrtec won’t do you much good.
To summarize, a medication within the anti-histamine drug class is potentially one of the mental health drugs that cause memory loss, especially a first generation.
Hope this helps clarify some of the mental health drugs that cause memory loss.
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