A recently published study shows that using antacids for a long duration may increase the risk of developing dementia.
The study, which was conducted by researchers at Karolinska Institutet in Sweden, shows that using acid suppressants called proton pump inhibitors (PPI) for heartburn, gastritis, stomach ulcers and other conditions may lead to cognitive decline down the road, according to a press release from the Swedish medical university.
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“We’ve been able to show that proton pump inhibitors affect the synthesis of the neurotransmitter acetylcholine, which plays a significant part in conditions such as Alzheimer’s disease,” Taher Darreh-Shori, senior researcher at the department of neurobiology, care sciences and society at the Karolinska Institutet said in a statement.
“Since there’s no effective treatment for the disease, it’s important to avoid risk factors. We therefore want to draw attention to this so that the drugs aren’t used needlessly for a long time,” Darreh-Shori said.
In the study, researchers used 3D computer simulations to analyze how six proton pump inhibitor variants interacted with an enzyme called choline acetyletransferase. The enzyme’s function is to synthesize the neurotransmitter acetylcholine. The PPI variants were based on different active substances.
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Acetylcholine is needed as a neurotransmitter for passing signals among nerve cells. However, this only works if enough of the substance is produced. Researchers’ simulations revealed all the tested drugs could bind with the enzyme.
Then, researchers examined the effect of the binding. They discovered the drugs inhibited the enzyme, leading to lowered production of acetylcholine. In that case, stronger binding resulted in a stronger inhibitory effect.
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To analyze whether laboratory examinations show what happens in the body, complementary studies are needed.
But Darreh-Shori is going ahead and warning against overusing PPIs.
“Special care should be taken with the more elderly patients and those already diagnosed with dementia,” he said. “The same also applies to patients with muscle weakness diseases such as ALS, as acetylcholine is an essential motor neurotransmitter. In such cases, doctors should use the drugs that have the weakest effect and prescribe them at lowest dose and for as short a time as possible.”
Still, he added, “the correct use of the drugs is safe also in the elderly, as long as the drugs are used for a limited time and when they’re really needed, as our nervous system is pretty flexible when it comes to tolerating short-term impact.”
