Can antipsychotic medications worsen memory in the elderly?
Antipsychotic medications can sometimes worsen memory in older adults, especially those with dementia or delirium, due to side effects like sedation and cognitive impairment. Doctors often use these drugs at low doses to calm agitation, but they carry risks that affect thinking and recall.
In elderly patients, antipsychotics help control severe agitation or psychosis when other methods fail. For example, low-dose risperidone is common because it has fewer anticholinergic effects, which block acetylcholine, a brain chemical key to memory formation. Blocking acetylcholine can lead to confusion and poorer memory, making symptoms worse in people already struggling with dementia.[1] Still, both typical and atypical antipsychotics are linked to cognitive slowdown and sedation, which cloud memory and focus.[5]
Not all antipsychotics act the same way. Some, like quetiapine or olanzapine, are used in small amounts for older patients over 75, but they respond less well and face higher risks like falls or stroke.[2] High doses or mixing drugs can oversedate, further harming memory. Benzodiazepines, sometimes given alongside, also impair new memory formation.[1]
Studies show antipsychotics are not approved for dementia-related psychosis because they raise death risk in older adults.[4] Long-term use adds to cognitive burden, with some reports of lasting memory issues. Anticholinergic traits in certain antipsychotics mimic effects seen in over-the-counter drugs tied to dementia risk.[4]
Doctors stress trying non-drug options first, like therapy or environment changes, before antipsychotics. When needed, start with the lowest dose and watch closely for memory changes or confusion.
Sources
https://www.hmpgloballearningnetwork.com/site/altc/articles/scheduled-low-dose-risperidone-agitation-elderly-patients
https://www.droracle.ai/articles/659438/when-should-antipsychotic-medication-be-used-in-patients-with
https://pmc.ncbi.nlm.nih.gov/articles/PMC12734372/
https://medshadow.org/conditions-treatments/alzheimers-dementia/the-link-between-dementia-alzheimers-and-common-meds/
https://www.droracle.ai/articles/594605/what-medications-can-cause-memory-loss
https://www.aol.com/articles/powerful-antipsychotic-drugs-given-dementia-223907400.html
