The first study to examine the use of tricyclic antidepressants for treating diabetic peripheral neuropathy in healthcare facilities serving low-income and diverse populations has been conducted. Previous research, mostly conducted by scientists, has shown a connection between long-term use of anticholinergic drugs like tricyclic antidepressants and cognitive decline, including dementia. Studies have indicated that the use of anticholinergic drugs in older adults can increase the risk of dementia by 30 to 50 percent. <p id=”first” cl
Many adults with diabetes and the related issue of peripheral neuropathy, which can be both painful and damaging, are often given medications at doses and for lengths of time that could increase the risk of cognitive impairment.
A recent study, conducted by Regenstrief Institute and Purdue University College of Pharmacy Research Scientist Noll Campbell, PharmD, M.S., is one of the first looks at the prescribing patterns of tricyclic antidepressants for diabetic peripheral neuropathy treatment at healthcare facilities that mainly serve diverse low-income populations.
rnrnThe study included adults 18 years and older, 44 percent of whom were White and 42 percent were Black. The researchers discovered that nearly 66 percent of the prescribed tricyclic antidepressants exceeded the recommended dosage, which has been linked to a higher risk of dementia in older adults. Black patients were more likely to receive these drugs at higher doses, significantly increasing their risk of dementia compared to White patients.
Existing evidence, including research conducted by Regenstrief Institute scientists, strongly suggests a connection between long-term dosage of tricyclic antidepressants and dementia risk.The utilization of anticholinergic medications, such as tricyclic antidepressants, has been linked to cognitive impairment, including dementia. Studies indicate that the use of anticholinergics in older adults can significantly increase the risk of dementia by 30 to 50 percent.
Diabetic peripheral neuropathy is a condition that occurs when nerve damage affects neurological function in the extremities, leading to symptoms such as pain, numbness, susceptibility to infection, and other complications. This condition is relatively common among adults who have long-term or uncontrolled Type I or Type II diabetes. Current guidelines for diabetes care recommend the use of tricyclic antidepressants to manage pain alongside existing diabetic conditions.prescriptions for treating depression. However, these guidelines do not discuss the potential risks associated with long-term usage of these medications, which are designed to affect the nerves and brain.
“After analyzing data from electronic health records, we observed that tricyclic antidepressants were being prescribed to individuals with diabetes for extended periods, ranging from five to nine years, at a rate that results in about two thirds of tricyclic antidepressant users being at a higher risk for dementia,” stated Dr. Campbell, a researcher specializing in aging brain and pharmacy services. “Discontinuing the use of these medications may reduce the risk of dementia, and there are alternative medication options that are not linked to cognitive impairment that may be considered.”There is very little evidence of routine drug efficacy evaluation happening in clinical care. Older Black adults in the U.S. are diagnosed with dementia at a higher rate than older White adults. It is not clear if this is due to the disease itself or the medications they are taking. While it may be difficult to change the disease, it is possible to modify the types of medications used to manage these disease states.
