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8 Medications That May Affect Memory and Cognitive Health
Memory lapses can happen to anyone, especially during periods of stress, poor sleep, illness, or major life changes. But if you have recently noticed increased forgetfulness, confusion, difficulty concentrating, or a feeling of mental “fog,” your medications may deserve a closer look.
Certain prescription and over-the-counter medicines can affect the brain and nervous system. Some may temporarily cause drowsiness, confusion, slowed thinking, or problems with attention and memory. The risk can be greater in older adults, particularly when several medications are taken together. The National Institute on Aging recommends discussing medications and possible effects on memory, sleep, and brain function with a healthcare professional.
This does not mean that these medications are inherently bad or that you should stop taking them. Many are important and effective treatments for serious health conditions. Instead, knowing which medication groups can potentially affect cognition can help you have a more informed conversation with your doctor or pharmacist.
Below are eight medication categories worth knowing about.
1. Anticholinergic Medications
Anticholinergic medicines are among the most important medication groups to consider when evaluating memory or cognitive changes.
These drugs work by blocking the action of acetylcholine, a chemical messenger involved in many bodily functions, including aspects of learning and memory. Anticholinergic effects can occur with medications used for several conditions, including overactive bladder, allergies, gastrointestinal problems, and some mental health conditions.
Possible cognitive effects can include:
- Difficulty concentrating
- Confusion
- Drowsiness
- Problems with short-term memory
- Mental fog
- In some cases, delirium
Older adults may be particularly sensitive to these effects. The National Institute on Aging specifically recommends reassessing anticholinergic medications when an older person develops cognitive impairment.
Research has also raised concerns about long-term exposure to medications with strong anticholinergic effects. An NIA-supported observational study found an association between greater cumulative exposure and increased dementia risk in older adults. Importantly, an association does not prove that these medications directly cause dementia, and medication decisions should be individualized.
Examples may include: certain bladder medications, some older antidepressants, and medications used for gastrointestinal spasms.
2. Benzodiazepines
Benzodiazepines are prescription medications commonly used for anxiety, panic disorders, insomnia, and certain seizure conditions.
Examples include medications such as alprazolam, lorazepam, clonazepam, and diazepam.
Because these medicines slow activity in the central nervous system, they can cause:
- Drowsiness
- Slower reaction times
- Reduced alertness
- Difficulty concentrating
- Confusion
- Memory problems
These effects can be especially noticeable in older adults.
The U.S. Food and Drug Administration has issued a boxed warning for the benzodiazepine class because of risks including misuse, addiction, physical dependence, and withdrawal. Cognitive impairment can also occur, including during withdrawal.
If you have been taking a benzodiazepine regularly, do not suddenly stop it on your own. Abrupt discontinuation can cause potentially serious withdrawal symptoms, including seizures. A healthcare professional can determine whether the medication remains appropriate and, if necessary, develop a gradual tapering plan.
3. Certain Sleep Medications
Some medications used to treat insomnia can affect alertness, attention, and memory.
Prescription sleep medicines, including certain non-benzodiazepine hypnotics, can cause next-day drowsiness or reduced mental alertness. Some people may also experience confusion or memory-related side effects.
For example, MedlinePlus notes that eszopiclone can cause daytime drowsiness and decreased mental alertness and lists memory problems and confusion among symptoms that should be discussed with a healthcare professional.
Sleep medications can become particularly concerning when combined with other medicines that depress the central nervous system.
It is also worth remembering that poor sleep itself can impair concentration and memory. Therefore, simply removing a sleep medication is not always the answer. Your healthcare provider may need to determine whether the medication, the underlying sleep problem, or both are contributing to cognitive symptoms.
4. Some Antihistamines
Antihistamines are widely used for allergies, itching, colds, and other symptoms. Some older antihistamines have significant anticholinergic effects and can cause drowsiness and cognitive problems.
Diphenhydramine, for example, is found in some allergy products and nighttime cold or sleep preparations. Because it can have strong anticholinergic effects, it may be particularly problematic for some older adults.
The National Institute on Aging lists antihistamines among medications that can impair cognition in older adults.
Potential effects may include:
- Sleepiness
- Slower thinking
- Difficulty concentrating
- Confusion
- Short-term memory difficulties
This is one reason it is important to look beyond prescription medications when reviewing memory changes. An over-the-counter allergy or nighttime product may also contribute.
Always check the active ingredients in combination cold, allergy, and sleep products so that you do not accidentally take multiple medicines with similar effects.
5. Opioid Pain Medications
Opioids are powerful pain-relieving medications prescribed for moderate to severe pain in certain situations.
Examples include morphine, oxycodone, hydrocodone, and fentanyl.
While opioids can provide important pain relief, they can also affect the central nervous system. Side effects may include:
- Drowsiness
- Confusion
- Reduced alertness
- Dizziness
- Difficulty concentrating
- Problems with coordination
Mayo Clinic identifies opioids among medications that can be associated with impaired cognition.
The cognitive effects may be more noticeable when opioids are combined with other sedating substances or medications. The risk can also increase with higher doses or in people who are particularly sensitive to these medicines.
Importantly, untreated severe pain can also interfere with sleep, concentration, and everyday functioning. Therefore, the goal is not simply to avoid pain medication but to find the safest and most effective treatment plan for the individual.
6. Certain Antiseizure Medications
Antiseizure medications, also called anticonvulsants, are primarily prescribed to control seizures. Some are also used for nerve pain, migraine prevention, or other conditions.
Because these medicines affect electrical activity and chemical signaling in the brain, some can cause neurological side effects such as:
- Sleepiness
- Slowed thinking
- Difficulty concentrating
- Confusion
- Problems finding words
- Memory difficulties
The effects vary substantially from one medication to another.
For example, MedlinePlus lists difficulty concentrating, confusion, memory problems, and speech problems among possible serious side effects associated with topiramate.
This does not mean that everyone taking an antiseizure medication will experience cognitive problems. In many cases, these medicines are essential for controlling seizures, and uncontrolled seizures can themselves affect cognition and safety.
If cognitive symptoms begin after starting a medication or increasing its dose, tell your prescriber. They can determine whether the symptoms could be medication-related and whether an adjustment is appropriate.
7. Corticosteroids
Corticosteroids, sometimes simply called steroids, are used to reduce inflammation and suppress immune activity. Examples include prednisone, prednisolone, and related medicines.
They are prescribed for a wide range of conditions, from inflammatory diseases and allergic reactions to certain respiratory and autoimmune conditions.
Corticosteroids can sometimes affect mood, sleep, and mental function. Depending on the medication, dose, and individual circumstances, possible effects can include:
- Insomnia
- Mood changes
- Anxiety or agitation
- Confusion
- Changes in behavior
- In rare cases, severe psychiatric symptoms
For example, MedlinePlus lists confusion and major mood or personality changes among potentially serious reactions to prednisone.
Because corticosteroids can be medically important, they should not be stopped abruptly unless a healthcare professional specifically instructs you to do so. The appropriate approach depends on the particular medication, dose, duration of treatment, and underlying condition.
If you notice substantial changes in mood, behavior, thinking, or sleep after starting a corticosteroid, contact your healthcare provider.
8. Muscle Relaxants and Other Sedating Medications
Muscle relaxants are commonly used for muscle spasms, stiffness, and certain painful musculoskeletal conditions. Many can cause sedation, dizziness, and reduced alertness.
The National Institute on Aging lists muscle relaxants among medications that can impair cognition in older adults.
Potential effects include:
- Sleepiness
- Dizziness
- Slowed reaction time
- Confusion
- Difficulty concentrating
- Reduced coordination
The concern becomes greater when a person takes several medications with sedating effects at the same time.
For example, an older adult taking a muscle relaxant alongside an opioid, benzodiazepine, or sleep medication may experience more pronounced central nervous system effects than with any one medicine alone.
This is why a complete medication review is often more useful than looking at a single prescription in isolation.
Why Older Adults May Be More Sensitive
Medication-related cognitive problems can occur at any age, but older adults may be particularly vulnerable.
As people age, the body can process medications differently. Kidney and liver function may change, body composition can change, and people may also take multiple medications for different chronic conditions.
The 2023 American Geriatrics Society Beers Criteria identifies medications that may be potentially inappropriate for many adults aged 65 and older because their risks can outweigh their benefits in particular circumstances. The criteria are intended to support clinical decision-making rather than automatically label every medication as unsafe.
Another important issue is polypharmacy, or taking multiple medications. The more medicines a person takes, the more opportunities there are for drug interactions and overlapping side effects.
The National Institute on Aging notes that combinations of central nervous system medications can increase the risk of serious side effects and that some CNS-active drugs can affect thinking and memory.
Signs That a Medication May Be Affecting Memory
A medication-related cognitive problem may appear in several ways.
You might notice:
- New forgetfulness after starting a medicine
- Difficulty following conversations
- Increased daytime sleepiness
- Trouble finding familiar words
- Unusual confusion
- Difficulty concentrating
- Feeling mentally foggy
- Increased dizziness or unsteadiness
- Changes in alertness after taking a dose
Pay attention to timing. If symptoms consistently appear after taking a particular medication, after a dose increase, or after adding another drug, tell your healthcare professional.
However, timing alone cannot prove that a medication is responsible.
Memory changes can have many causes, including sleep problems, depression, thyroid disorders, nutritional deficiencies, infections, dehydration, hearing or vision problems, and neurological conditions. The National Institute on Aging emphasizes that finding the underlying cause of memory problems is important for choosing the right treatment.
What to Do If You Suspect Your Medication Is Affecting Your Memory
The safest first step is to schedule a medication review with your doctor or pharmacist.
Bring a complete list that includes:
- Prescription medications
- Over-the-counter medicines
- Vitamins
- Dietary supplements
- Herbal products
- Medication doses
- How often you take each product
The FDA recommends keeping an up-to-date medication list and discussing possible medication side effects with a healthcare professional.
During a medication review, your healthcare professional may consider whether:
- A particular medication can cause cognitive side effects.
- Your current dose is appropriate.
- Two or more medications may be interacting.
- A safer alternative is available.
- The medication is still necessary.
- Another health condition could explain the memory changes.
Sometimes the solution may be adjusting the dose, changing the timing, switching medications, or treating another underlying problem.
Never Stop a Prescription on Your Own
One of the most important points is that you should not stop a prescription medication simply because you read that it may affect memory.
Some medications need to be reduced gradually to prevent withdrawal or other complications. Benzodiazepines are a particularly important example because abrupt discontinuation can result in serious withdrawal reactions.
Other medications may be controlling conditions where suddenly stopping treatment could also be dangerous.
Instead, speak with your doctor or pharmacist and explain exactly what you have noticed.
When Memory Changes Need Prompt Medical Attention
New or rapidly worsening confusion should not automatically be blamed on medication.
Sudden confusion, major changes in alertness, hallucinations, difficulty speaking, weakness, severe headache, loss of consciousness, or other abrupt neurological symptoms can require urgent medical evaluation.
Likewise, if memory problems are progressively interfering with medication management, driving, finances, cooking, work, or daily activities, arrange a medical assessment rather than assuming the changes are simply part of normal aging.
Frequently Asked Questions
Can medications really cause memory loss?
Yes. Some medications can cause confusion, impaired attention, sedation, or memory problems, particularly in older adults. The effect depends on the medication, dose, duration of use, individual health, and interactions with other medicines.
Does medication-related memory loss mean I have dementia?
No. Memory problems can have many causes, and some medication-related cognitive effects may improve when the underlying medication issue is addressed. A healthcare professional can help determine the cause.
Should I stop taking a medication if I think it is affecting my memory?
No. Do not stop prescribed medication without medical advice. Some medicines require gradual dose reduction, while others are essential for managing serious conditions.
Are over-the-counter medicines included?
Yes. Some OTC allergy, cold, and sleep products contain ingredients that can cause drowsiness or anticholinergic effects. Always check the active ingredients and discuss regular OTC medication use with your healthcare professional.
Can taking several medications increase cognitive side effects?
It can. Multiple medications may interact or produce overlapping effects such as sedation and confusion. This is particularly relevant when several central nervous system medicines are used together.
Final Takeaway
Several commonly used medications can potentially affect memory, attention, alertness, or other aspects of cognitive health. The eight groups discussed here include anticholinergic medications, benzodiazepines, certain sleep medicines, some antihistamines, opioids, certain antiseizure medications, corticosteroids, and muscle relaxants.
That does not mean these medicines should automatically be avoided. In many cases, their benefits are substantial and may outweigh potential side effects. The key is recognizing possible warning signs and having regular medication reviews—especially if you take multiple prescriptions or are experiencing new cognitive changes.
If you have noticed unexplained forgetfulness, confusion, or mental fog, make a complete list of everything you take and discuss it with your doctor or pharmacist. A medication review can be an important step toward identifying a potentially treatable contributor to cognitive symptoms.
Medical disclaimer: This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Medication effects vary from person to person. Never start, stop, or change the dose of a prescription medication without consulting a qualified healthcare professional.
