Improving Your Memory (9 page)

Some Medications

Prescription and over-the-counter medications can affect your memory, because they can slow your thinking and make you feel drowsy or foggy. They can diminish your attention or concentration, making it harder to register information in your working memory.

Most, but not all, of the time, memory is affected within days after starting a new medication or increasing the dose. Sometimes the change is noticed by the person taking the medication, and sometimes the change is more noticeable to other people. A memory problem due to medication is seldom permanent, however. In fact, the problem may go away on its
own as you continue to take the medicine and your body adjusts to it. If the problem doesn’t go away, talk with your doctors to find out if there are other medications you can take instead.

No one can tell who will have a memory problem from a medication, and it can happen to anyone. Some things, however, make a person more likely to have memory problems with medications:

• Side effects from medications in the past

• Low weight

• Older age

• A sudden change in health

• Taking several other medications

• Taking more (or less) of a medication than you are supposed to

• Taking a medication in combination with alcohol

• A medical condition like Alzheimer’s disease that is already affecting memory

• Some kinds of liver disease

• Heart failure

• Kidney failure

Although some medications affect memory and attention more than others do, the same medications don’t cause the same problems in everyone. Medications that have a higher risk of memory problems include

• Prescription sleeping or anxiety medications
Ambien (zolpidem)
Ativan (lorazepam)
Lunesta (eszopiclone)
Sonata (zaleplon)
Valium (diazepam)
Xanax (alprazolam)

• Urinary incontinence medications
Detrol (tolterodine)
Ditropan or Oxytrol (oxybutynin)
Enablex (darifenacin)
Sanctura (trospium)
Toviaz (fesoterodine)
Vesicare (solifenacin)

• Muscle relaxants
Lioresal (baclofen)
Flexeril (cyclobenzaprine)
Skelaxin (metaxalone)
Soma (carisoprodol)

• Neurontin (gabapentin)

• Over-the-counter allergy or sleeping pills
Benadryl or Sominex (diphenhydramine)
Chlor-Trimeton (chlorpheniramine)
Unisom (doxylamine)

• Narcotic pain medications
MS Contin and other brands of morphine
Duragesic or Actiq (fentanyl)
Oxycontin and other brands of oxycodone

hydrocodone (found in Vicodin, Norco, Lortab and other brands)

The effect of “statin” cholesterol-lowering medications is unclear. When starting treatment, they might cause memory problems in some people. But if taken for a year or more, they might reduce the chance for dementia. They include

Crestor (rosuvastatin)

Lescol (fluvastatin)

Lipitor (atorvastatin)

Mevacor (lovastatin)

Pravachol (pravastatin)

Zocor (simvastatin)

Memory problems can happen at any time during treatment, but they happen more often when getting started or when increasing the dose.

Medications are only one of many causes of memory problems. If you think you are having a memory problem from a medication, you should talk to your doctors or pharmacists.
Never stop or reduce your medications on your own.
You and your doctor can together decide whether your memory problem may be due to the medication and what to do about it.

When it comes to side effects of medicines, prevention is key. You can be a partner in preventing memory problems due to medications by

• Keeping a list of medications and showing it to your doctors and pharmacists before you start or change the dose of a medicine

• Working with your doctors to try to stop medications you may no longer need

• Not drinking alcohol if you think your memory might be affected by your medications

• Talking with your doctors or pharmacists about scheduling the taking of your medications to lessen their effect on your memory

• Telling your doctors and pharmacists if you think your memory is affected by a medicine, so that they can try to prevent this problem from happening again with the same or similar medications
(This section on medications was written by Tami Remington, Pharm.D., Clinical Associate Professor, University of Michigan, Ann Arbor.)

EXAMPLE

Tom has been feeling tired and foggy, and he is forgetting more than he used to. His daughter suggests that he see his family doctor for consultation. Dr. Brown takes a complete history, including a review of medications. She discovers that Tom has begun to take over-the-counter sleeping pills to treat his insomnia, along with the blood pressure medication that she had prescribed at the last visit. Dr. Brown recognizes that the combination of the two drugs could be causing Tom’s fatigue and memory problems. She prescribes a short-acting sleeping pill, so that this medication will be out of Tom’s system during the daytime. Tom finds that, over time, his memory improves with this adjustment of medications.

Vision and Hearing Problems

A person with vision or hearing problems may blame his memory if he can’t recall information or experiences. In fact, the problem may not be in the memory at all. When you can’t see or hear clearly, the information will not be encoded correctly. It is important to admit when you can’t hear adequately and ask others to speak up. If you are unable to read printed material, ask for a large-print copy or ask someone to read it to you. Get regularly scheduled vision and auditory tests to make sure that you are getting the eyeglasses and hearing aids you need. Vision and hearing abilities can change dramatically, and new technology may compensate for losses.

EXAMPLES

Your neighbor suggests that you call a Realtor whose name is Abbott. When you call the realty company, you ask for Mr. Babcock. The problem here may not be your memory; your neighbor may have mumbled, or you may have trouble hearing. If you want to remember something correctly, ask the person to repeat it, spell it, and write it down.

At the doctor’s office, the receptionist gives you an insurance form to complete at home. “Sign in these three places, and mail it off,” she says, pointing to three blanks. When you get home, you are confused by all the blank spaces and say, “I’ve already forgotten what she told me.” The problem may not be in your memory. You may not have seen the spaces she pointed to. Next time, ask her to mark the spaces with a red X.

Fatigue

Fatigue affects concentration and slows down the recall process. We are more likely to have trouble learning new information, because focus and attention are impaired when we’re tired. If we can figure out which times of the day we are most alert, we can do tasks that involve new learning at those times.

If insomnia is a problem for you, consider talking to your doctor about it. (A good website on sleep habits is
http://healthysleep.med.harvard.edu/
.)

EXAMPLES

You usually read at bedtime because it puts you to sleep. However, you can’t keep the characters straight in the book you’re reading, and this frustrates you. You might try reading the book when you are more alert. If you want to read before dozing off, read something you don’t care about remembering.

You have just finished attending the third lecture of a six-week series on health problems at your local library. You were especially looking forward to last week’s lecture on diabetes, because your husband has diabetes in his family. You realize, however, that you remember little of the material because you were especially tired that day. For the next lecture, you resolve to be rested and ready to take notes.

Alcohol

Alcohol can affect your memory in two different ways. First, many people find that they are less able to tolerate alcohol as they grow older; two drinks may have been tolerated well in the past but are now too much. As far as memory is concerned, there is a greater effect on the brain if you have four drinks in one night than if you have one drink on each of four nights. Second, long-term abuse of alcohol can cause irreversible memory loss.

In addition to the direct effects of alcohol on memory, alcohol consumption can cause or make worse other factors that affect your memory:

•
Depression
: Alcohol acts as a depressant on the central nervous system.

•
Decreased nutritional status
: Some people who drink excessively do not eat an adequate or nutritious diet.

Poor Nutrition

We read articles and see news reports all the time about foods that are thought to be beneficial or harmful for health and cognition. Some foods that have been on the “bad foods” list have been redeemed and now are recommended in moderation. Reversals like this make it very difficult to know what specific foods we should eat to help our brains be healthy, even as researchers vigorously investigate whether certain foods can improve brain function.

What we do know is that a balanced diet contributes to overall health. The best advice at this time is to eat fresh fruits and vegetables, whole-grain cereals and breads, and a variety of foods rich in protein.

13
Let’s Review Again

Are you frustrated because you forgot to mail a birthday card? Are you avoiding social occasions because you don’t have the energy? Did you miss an important meeting because you entered it wrong on your calendar? Are you misplacing things more often than you used to?

So far in this book we have looked at the different factors that affect memory. Now we ask you to think about which of these factors might be affecting you.

Once you have identified the factors that are affecting you, you may wish to go back and reread the information in
chapters 9
–
12
about those factors. To address some of these factors, you may need to see a physician, counselor, or other professional for treatment. For other factors, you may find ways to make changes in your environment or lifestyle to address the problem. To get you started,
part IV
is full of memory improvement techniques that many people find effective.

SELF-INVENTORY OF FACTORS AFFECTING MEMORY

EXERCISE: FACTORS THAT AFFECT MEMORY