7 Medications That May Affect Memory and Brain Health

Memory changes are often associated with aging, stress, poor sleep, or medical conditions. But there is another factor that is sometimes overlooked: medication side effects.

Some prescription and over-the-counter medicines can cause drowsiness, confusion, difficulty concentrating, or short-term memory problems. These effects may be particularly noticeable in older adults because the body can process medications differently with age. The National Institute on Aging recommends reviewing prescription drugs, over-the-counter medicines, and supplements when assessing new cognitive problems, particularly medications with anticholinergic or sedating effects.

This does not mean that these medications are always harmful or that everyone who takes them will develop memory problems. Many are useful and sometimes essential treatments. The goal is to recognize medications that may contribute to cognitive symptoms so patients and healthcare professionals can make informed decisions.

Below are seven medication groups that may affect memory, alertness, or other aspects of brain function.

1. Anticholinergic Medications

Anticholinergic medicines are among the most important medication groups to consider when an older adult develops unexplained confusion or memory problems.

These medicines work by blocking the action of a neurotransmitter called acetylcholine. Acetylcholine plays an important role in memory, learning, attention, and other nervous-system functions.

Anticholinergic effects can occur with medications used for several different conditions, including allergies, bladder problems, motion sickness, depression, and certain gastrointestinal conditions.

Some commonly encountered examples include certain first-generation antihistamines and some medications used to treat overactive bladder.

Potential cognitive side effects can include:

• Confusion
• Difficulty concentrating
• Drowsiness
• Short-term memory problems
• Reduced alertness
• Problems with thinking or attention

The risk can become more important when a person takes several medicines with anticholinergic properties at the same time. The American Geriatrics Society’s Beers Criteria specifically identifies several medications with anticholinergic effects as potentially inappropriate for many older adults.

Why older adults may be more vulnerable

As people age, changes in kidney and liver function can affect how medications are processed. Older adults are also more likely to take multiple medications, increasing the possibility of drug interactions and cumulative side effects.

If memory or confusion changes after starting an anticholinergic medication, a medication review with a healthcare professional may be worthwhile.

2. Benzodiazepines

Benzodiazepines are prescription medicines commonly used for anxiety, certain seizure disorders, and sometimes insomnia.

Examples include medications such as alprazolam, lorazepam, clonazepam, and diazepam.

These drugs slow activity in the central nervous system. As a result, they can cause sedation, impaired alertness, and problems with coordination. In some people, especially older adults, they may also contribute to cognitive impairment.

The American Geriatrics Society Beers Criteria recommends avoiding benzodiazepines in many older adults because of risks that include cognitive impairment, delirium, falls, and fractures.

The U.S. Food and Drug Administration has also issued a boxed warning for the benzodiazepine class because of risks involving misuse, addiction, physical dependence, and withdrawal. Withdrawal can include symptoms such as memory impairment and other nervous-system effects.

Important: don’t stop suddenly

Someone who has been taking a benzodiazepine regularly should not abruptly discontinue it without medical supervision. Physical dependence can develop even when the medicine is taken as prescribed, and sudden discontinuation can cause potentially serious withdrawal reactions, including seizures.

If you are concerned that a benzodiazepine is affecting memory, talk to the prescribing clinician about whether the medication, dose, or duration of treatment should be reassessed.

3. Prescription Sleep Medicines

Certain prescription sleep medicines can affect alertness, attention, balance, and memory.

The so-called Z-drugs, including zolpidem, eszopiclone, and zaleplon, are commonly prescribed for insomnia. Although they are chemically different from benzodiazepines, they can have similar sedating effects.

Older adults may be particularly sensitive to these effects.

Possible problems can include:

• Daytime drowsiness
• Reduced concentration
• Confusion
• Impaired coordination
• Memory problems
• Increased risk of falls

The 2023 AGS Beers Criteria lists nonbenzodiazepine benzodiazepine-receptor agonist hypnotics, commonly known as Z-drugs, among medications that can pose significant risks to older adults.

Don’t assume better sleep always means better brain health

Sleep is extremely important for memory and cognitive function. However, using a sedating medication does not necessarily produce the same restorative benefits as healthy natural sleep.

For persistent insomnia, healthcare professionals may recommend reviewing sleep habits, underlying medical conditions, other medications, and behavioral approaches before relying on long-term sedative treatment.

4. Opioid Pain Medications

Opioids are powerful pain-relieving medicines used for moderate to severe pain. Examples include morphine, oxycodone, hydrocodone, and fentanyl.

When appropriately prescribed and monitored, opioids can be valuable medical treatments. However, they can also cause sedation and impair attention or mental alertness.

Some people may experience:

• Sleepiness
• Confusion
• Dizziness
• Difficulty concentrating
• Reduced alertness
• Problems performing complex tasks

The effects can be more pronounced when opioids are combined with other sedating medications.

The National Institute on Aging specifically recommends reviewing narcotic medications when an older adult develops cognitive impairment.

Older adults taking opioids should follow the prescribed dosage carefully and tell their healthcare professional about all other medications they use.

5. Certain Antidepressants

Antidepressants are widely used and can be very beneficial for depression, anxiety, and other conditions. However, some antidepressants have stronger anticholinergic or sedating properties than others.

Tricyclic antidepressants (TCAs) are one group that deserves particular attention in older adults. Examples include amitriptyline, imipramine, and nortriptyline.

Some of these medications can cause anticholinergic effects, including:

• Dry mouth
• Constipation
• Blurred vision
• Drowsiness
• Confusion
• Difficulty concentrating

Because of these potential effects, several tricyclic antidepressants are included in the AGS Beers Criteria as medications that are generally best avoided in many older adults.

This does not mean that every person taking an antidepressant should switch medications. Depression itself can significantly affect concentration and memory, so treating the underlying condition can sometimes improve cognitive function.

The appropriate choice depends on the individual’s symptoms, medical history, other medications, and response to treatment.

6. Certain Antipsychotic Medications

Antipsychotic medicines are prescribed for conditions such as schizophrenia and bipolar disorder and may sometimes be used in specific situations involving severe behavioral symptoms.

However, these medications can cause sedation and other effects on thinking and movement. Older adults can be especially vulnerable to adverse effects.

The AGS Beers Criteria recommends avoiding antipsychotics for behavioral problems associated with dementia unless certain specific circumstances apply, such as when non-drug approaches have failed and the person poses a substantial risk of harm to themselves or others.

Antipsychotic medications should therefore be used under careful medical supervision.

If a person experiences new or worsening confusion, excessive sleepiness, movement problems, or other concerning symptoms after beginning an antipsychotic, the prescribing healthcare professional should be informed.

7. Certain Antiseizure and Other Sedating Medications

Some antiseizure medicines can affect alertness, concentration, balance, or mental processing. These medications are prescribed for epilepsy and, in some cases, other conditions such as certain types of nerve pain.

The effects vary considerably depending on the medication, dosage, individual response, and other drugs being taken.

For example, antiseizure medicines may sometimes cause:

• Drowsiness
• Slowed thinking
• Dizziness
• Difficulty concentrating
• Coordination problems

This is particularly important when several medications with sedating effects are taken together.

Importantly, antiseizure medicines should never be stopped suddenly without medical advice, because doing so can potentially trigger seizures or other serious problems.

A doctor or pharmacist can determine whether a medication is contributing to cognitive symptoms and whether an adjustment is appropriate.

Why Medications Can Affect Memory

Medication-related memory problems do not necessarily mean that a medicine is permanently damaging the brain.

A drug can temporarily interfere with cognitive function through several mechanisms.

For example, a medication may cause:

• Excessive sedation
• Reduced attention
• Confusion
• Anticholinergic effects
• Low blood pressure
• Electrolyte disturbances
• Drug interactions
• Sleep disruption

When attention is impaired, the brain may have difficulty properly forming or retrieving memories. What appears to be “memory loss” can sometimes actually be a problem with attention or alertness.

This is one reason a complete medication review can be useful when cognitive symptoms appear.

Who Is Most at Risk?

Medication-related cognitive side effects can happen at any age, but older adults may face additional risks.

The 2023 AGS Beers Criteria was specifically developed to help clinicians identify medications that may be potentially inappropriate for adults aged 65 and older. It emphasizes that these recommendations should support—not replace—individualized clinical decision-making.

Risk may be higher when someone:

• Takes many medications
• Has kidney or liver problems
• Has a history of falls
• Has existing cognitive impairment
• Takes several sedating medicines
• Uses both prescription and over-the-counter drugs
• Recently started a new medication
• Recently had a dosage increase

Taking multiple medications, often called polypharmacy, is common among older adults and can increase the likelihood of adverse drug events and medication-related problems.

What Should You Do If a Medication Seems to Affect Memory?

If memory problems begin soon after starting a medication, don’t immediately assume that the drug is the only cause. Many other conditions can affect memory, including sleep disorders, depression, infections, metabolic problems, nutritional deficiencies, and neurological diseases.

Instead, consider the following steps:

1. Make a complete medication list

Include:

• Prescription medicines
• Over-the-counter products
• Vitamins
• Herbal supplements
• Sleep aids
• Allergy medicines
• Pain relievers

2. Record when symptoms started

Write down when you first noticed memory problems or confusion and whether the symptoms changed after a medication was started or its dose was changed.

3. Ask for a medication review

A doctor or pharmacist can assess whether one or more medicines could be contributing to the symptoms.

4. Never stop important medications on your own

Some medicines can cause dangerous withdrawal effects or worsening of the underlying condition when suddenly discontinued.

5. Ask whether safer alternatives exist

Depending on the condition being treated, there may be non-drug approaches, a different medication, or a lower-risk treatment option. A 2025 American Geriatrics Society publication specifically addresses alternative treatment strategies for medications identified in the Beers Criteria.

Frequently Asked Questions

Can medications cause temporary memory loss?

Yes. Some medications can cause confusion, sedation, impaired attention, or short-term memory difficulties. Whether the effect is temporary depends on the medication, dose, duration of treatment, and individual circumstances.

Do memory problems always mean a person has dementia?

No. Medication effects are among several possible causes of cognitive symptoms. A healthcare professional can help determine whether symptoms are related to medication, another medical condition, normal aging, or a neurological disorder.

Are all medications on this list bad for the brain?

No. That would be an inaccurate conclusion. These medication groups can be useful and sometimes necessary. The concern is that certain drugs may cause cognitive or sedating side effects in some people, particularly older adults.

Should older adults stop taking these medications?

No. Do not stop prescribed medication without speaking to a doctor or pharmacist. Some medications require gradual dose reduction, and abruptly stopping certain drugs can cause serious complications.

Can taking several medications increase the risk of memory problems?

It can. Taking multiple medications increases the possibility of drug interactions, cumulative sedation, and overlapping side effects. A medication review can help identify unnecessary or potentially problematic combinations.

Final Thoughts

Memory changes can have many causes, and medication is only one possibility. Nevertheless, certain medicines—including anticholinergic drugs, benzodiazepines, some sleep medications, opioids, certain antidepressants, antipsychotics, and some antiseizure medicines—can affect alertness, concentration, confusion, or memory in susceptible people.

This is particularly important for older adults, who may be more sensitive to medication side effects and more likely to take several medicines simultaneously. The American Geriatrics Society’s Beers Criteria provides clinicians with an evidence-based framework for identifying medications that may pose greater risks in older adults.

If you or a family member notices a sudden change in memory, confusion, unusual sleepiness, dizziness, or difficulty concentrating, consider discussing the complete medication list with a healthcare professional.

The goal isn’t simply to take fewer medicines. The goal is to use the right medicines, at the right doses, for the right reasons, while minimizing avoidable side effects.

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