What You Should Do
Older persons with HIV often have other age associated health problems, such as an overactive bladder or sometimes losing urine. In treating these annoying symptoms, doctors often use a certain type of medication called an anticholinergic drug. Common names of these are Toviaz, Ditropan XL, and Detrol. The drugs block the action of a chemical in your body (acetylcholine) that is a messenger from your brain to other organs. There has been a concern that these medications may adversely affect brain function. A new study supports this concern.
This study collected information on 209 people with HIV and 95 persons without HIV. Researchers asked participants how often they were taking the indicated mediations – Toviaz, Ditropan XL, and Detrol. The possible effect on the brain was assessed in 2 ways: Questions focusing on brain function – learning new material, memory, problem solving, motor speed and other brain activities. Secondly, use of brain imaging to determine brain size as well as the presence of abnormalities. This might include increased brain white matter which is indicative of damage.
Overall, more persons with HIV were taking the targeted medications than those without HIV. Importantly, these individuals were found to have more changes in brain function as measured by testing. And, they found that certain brain areas were smaller. In a subgroup who were in the study for two years, they found those who stopped had improvements in their psychological testing performance and neuroimaging measures. These negative results on brain function and size and the improvement with discontinuation of the medications should concern you enough to discuss this with your doctor. There may be other treatment options or that can address your complaints. Stay involved in the management of your health.
Cooley, S. A., et al. (2021). “Effects of anticholinergic medication use on brain integrity in persons living with HIV and persons without HIV.” AIDS 35(3): 381-391.