The Neuro-Protective Lifestyle

Take a moment and commit to memory (with the help of your hippocampus), the 10 early signs of Alzheimer’s. Baby-boomers will remember (hopefully) that Joni Mitchell said it best:

“don’t it always seem to go, that,

you don’t know what you’ve got til’ it’s gone“

Feel free to share this information with family and friends.
And remember, the memory you save may be your own….

1. memory loss
2. difficulty performing familiar tasks
3. misusing words
4. confusion about time and place
5. problems with judgement and reasoning
6. difficulties with abstract concepts
7. misplacing objects
8. personality change
9. mood change
10. loss of initiative

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photo credit: not persephone

Don’t panic if you find yourself occasionally taking one or two of the medications listed below. Do panic if you find yourself taking them indefinitely. There is an inevitable biochemical price to pay for every medication taken. As it goes in the macroscopic world - so it is in our micro-molecular environment. The trick of course is to achieve the maximum amount of good with the minimum amount of medication.

Some medications are so efficient at erasing memory that they are prescribed for that very purpose. Propranolol for instance is a non-selective ß-blocker ordinarily used for blood-pressure, heart rate control and persistent migraine. However, in the setting of post-traumatic stress disorder (PSTD), propranolol is very effective at eliminating intrusive memories caused by emotional trauma. That’s great if you have memories that need forgetting, otherwise it’s just a nasty side-effect you can do without.

Most anti-anxiety drugs are also capable of messing with memory. They have by design an “amnestic” property (anterograde amnesia) which makes them useful for treating anxious patients before certain medical procedures (CT scan, MRI for example), but not a great sleep aid. Used chronically benzodiazepines such as diazepam (Valium), interfere with the various stages of sleep, including REM sleep. REM (rapid eye movement) sleep is when critical components of memory consolidation occur for spatial and procedural memory in particular.

President Reagan is purported to have had an affinity for the benzodiazepine Halcion. Halcion is a very short acting anti-anxiety drug with some unusual side-effects. The “Our Man In Nirvana” article in the link above goes into greater detail. Halcion is now banned in several countries including the UK.

The class of drugs known as sedative-hypnotics have given rise to a plethora of bizarre complex sleep-related behaviors. There are now numerous reported cases of people “sleep-driving”, “sleep-eating”, engaging in “sleep-sex” and even “sleep-phone calling”, with no memory for the events later. These drugs work primarily in the suprachiasmatic nucleus (SCN), a region of the brain in front of the hypothalamus responsible for regulating our built-in circadian rhythms. Interrupting circadian rhythms can result in everything from simple jet-lag to serious mental health and mood disorders.

Don’t stop taking a medication just because you find it in the list below. Do take this list to your doctor and explore your options from a treatment standpoint. Very often an acceptable substitute can be found for the offending drug, or this may the time to give some non-drug alternatives a try.

Drop a comment (or two), if you need some help finding alternative treatment options. I’ll do my best to help.

Analgesics:

meperidine (Demerol),
hydrocodone (Vicodin),
oxycodone (Percocet, Oxycontin)

Antianxiety drugs:

alprazolam (Xanax),
diazepam (Valium)
lorazepam (Ativan)
oxazepam (Serax)
temazepam (Restoril)
triazolam (Halcion)

Anticholinergics:

oxybutinin (Ditropan, Oxytrol)

Antidepressants:

amitriptyline (Elavil)
imipramine (Tofranil)

Antihistamines:

diphenhydramine (Benadryl)
pseudophedrine (Sudafed)

Antinausea drugs:

hydroxyzine (Atarax)
meclizine (Antivert)
metoclopramide (Reglan)
prochlorperazine (Compazine)

Antihypertensives:

atenolol (Tenormin)
propranolol (Inderal)
metoprolol (Toprol)

Antipsychotics

chlorpromazine (Thorazine)
haloperidol (Haldol)
thioridazine (Mellaril)

Antiulcer drugs

ranitidine (Zantac)
cimetidine (Tagamet)

Parkinson’s:

amantadine (Symmetrel)

Seizure medications:

carbamazepine (Tegretol)
gabapentin (Neurontin)
valproic acid (Depakote)
pregabalin (Lyrica)
oxcarbazepine (Trileptal)

Sedative/Hypnotics:

zolpidem (Ambien)
eszopiclone (Lunesta)
ramelteon (Rozerem)

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If you’re worried that a loved one may be developing Alzheimer’s or another neurodegenerative disorder, this two minute test may be just what the doctor ordered. Administering the test is easy - but I can tell you as a physician and supposedly impartial third party, there is nothing more heart-wrenching than the look of dismay on a son or daughter’s face when an aging parent’s failing memory is finally revealed.

But first a word of caution.

The brevity of the test dictates that questions be cutting and candid. Also, for some, (especially those with mild memory impairment) the simplistic nature of the test questions may be taken as a personal affront. And remember, the answers must be timely and “spot-on” for the test to be properly interpreted.

Here we go.

First find a quiet familiar area without distractions. I always tell my patients before hand that I will be asking a series of questions designed to test their memory. I caution, that they may seem like “simple” questions, but to answer them anyway. If they are not sure about an answer, I encourage them to relax and just do their best.

ORIENTATION TEST

1. What year (month, day, date, time of day) is this?
The answers must be exact. Early memory impairment often reveals itself right here.

WORD REPETITION AND RECALL

2. Repeat after me: apple, table, penny (they must repeat the words clearly and recall all three within three minutes when you prompt them) See question #5.

LANGUAGE AND MEMORY LOSS

3. Name as many different vegetables/animals as you can. Say, “I will tell you when to start and stop”. (Time them for 1 minute, but don’t tell them that - fewer than 10 in one minute is an indication of early memory loss)

ATTENTION AND MEMORY

4. Spell “world” backwards or alternatively ask them to subtract 7 from 100 and then 7 from their answer (93) and so on. Trouble shows up early with this one (the third sequence) if memory impairment is present.

FINAL AND TOTAL RECALL

5. Ask them to recall the list given to them earlier (apple, table penny). Minimum acceptable recall is 2 out of 3 items.

That’s it! Practice on someone else ahead of time. The timing for recall of the list of items is important, as is the one minute limit on listing animal or vegetable names. Record the results and take them to your family member’s physician. He or she can help with proper interpretation of the test results.

Congratulations! You’ve just made a difference.

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