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Are Proton Pump Inhibitors Linked to Mental Health Issues?

Posted in Uncategorized on September 30, 2016

Proton pump inhibitors, medications for stomach issues, have been making headlines lately for a potential connection with mental health problems. If you’re thinking these medications won’t affect you, think again – they’re probably already in your medicine cabinet.

What is a Proton Pump Inhibitor (PPI)?

A proton pump inhibitor is a medication that reduces the amount of gastric acid your body produces. They are available by prescription and over the counter. Common non-prescription PPIs include Prilosec and Nexium. Prescription formations include AcipHex, Protonix, and Dexilant.  Doctors prescribe or recommend PPIs to treat GERD and peptic (stomach) ulcers.

Why Are Proton Pump Inhibitors (PPIs) Dangerous?

Recent studies have linked PPIs to a range of health problems. A study of 895 patients in Denmark found those who took PPIs were at increased risk for fluid buildup in the abdomen, a condition known as ascites. They also found that prolonged use of PPIs put patients at higher risk for hepatic encephalopathy, a condition in which the brain sustains damage when the liver is unable to filter toxins from the blood.

The authors of the study suggest caution in prescribing PPIs to patients with known liver conditions like cirrhosis.

PPIs and Risk of Infection

PPIs work by reducing the amount of stomach acid in your body in an effort to alleviate discomfort. But researchers are finding this has unintended consequences. Reduced gastric acid increases the pH of the stomach, creating bacteria overgrowth. These bacteria can make their way into the blood and lymphatics, which can lead to Spontaneous Bacterial Peritonitis, a risk factor for HE.

PPIs and Dementia 

Additionally, concerning is a recent study in the Journal of the American Medical Association (JAMA) suggests PPIs may be linked to dementia.

Researchers took information from 74,000 older adults without dementia in 2004, using information from German insurance claims. By 2011, physicians had diagnosed 40% of the initial group with dementia; 4% of these were taking PPIs regularly. After adjusting for age, stroke, and other potential confounds, researchers found long term PPI use put people at a 44% increased risk for dementia.

Scientists believe there may be a link between PPIs and the brain because PPIs cross the blood brain barrier. An accompanying editorial to the study, written by Lewis Kuller, M.D. D Ph., says that the problem may not be PPIs themselves, but PPIs in tandem with other medications.

Dementia: A Growing Problem

While current studies can’t establish a rigorous relationship between PPI use and dementia, we do know dementia is becoming a large-scale public health concern. Researchers estimate that 35 million people suffer from dementia worldwide, and this number is expected to increase 2.5 fold by the year 2040. It also affects us financially, carrying a price tag of $600 billion in 2010.

These numbers have many wondering why dementia numbers are growing, not shrinking. Why are we living longer than ever before? Other factors, like genetics and the environment, might be to blame. That’s why researchers are dedicating so much time to investigating the link between dementia and certain medications like PPIs.

I’m on a PPI. Now What?

If you routinely take an OTC or prescription PPI, talk to your doctor about the risks and benefits of continuing your medication. Your doctor can help you find alternative treatments for your gastrointestinal reflux or peptic ulcer.  Bring a list of all of your medications to your appointment to see if drug interactions are increasing your risk of dementia.

If you have cirrhosis or another liver condition, talk to your doctor about HE and steps you can take to prevent it. Consult with your doctor before stopping or switching any of your medications.