Heartburn Treatment and Mental Function

Many people take a histamine-2 blocker (or receptor antagonist) for their heartburn; these drugs reduce the amount of acid formed in the stomach and are useful in acid reflux (GERD, or gastro-esophageal reflux disease). Cimetidine (Tagamet®), famotidine (Pepcid®), and ranitidine (Zantac®) are the principal candidates. A study published in the Journal of the American Geriatrics Society found that regular use of a histamine-2 blocker may double the risk of developing signs of cognitive impairment, or imperfect mental functioning.

Over 1500 African Americans, who were free of any mental impairment at the outset, were followed for 5 years. Their medications intake – prescription and non-prescription – were determined by interview and in-home inspection of medicine cabinets. Analysis showed that 34% of continuous users of histamine-2 blockers developed cognitive impairment during follow-up, compared with 19.5% of intermittent users and 17% of non-users. A simultaneous analysis of proton-pump inhibitors (another class of anti-heartburn medications, which include omeprazole (Prilosec®) and esomeprazole (Nexium®), showed no association between their use and cognitive impairment.

This study has the minor drawback of being conducted in African Americans, and it doesn’t speak to the likelihood of the effect being found in other ethnic groups. However, there’s no reason to believe such an effect would be confined to one race. Further studies are required. In the meantime, it may be better to take Prilosec rather than Tagamet if you need a heartburn drug, all other things being equal.

Comments

[Elizabeth Evans]

I'm not a senior, but I am a regular Prilosec consumer due to persistent GERD. What puzzles me is the difference in outcomes betweeen a Tagamet and a Prilosec. Why would one cause mental impairment and the other be alright?

[Robert Griffith]

Elizabeth:
Tagamet belongs to one class of drugs (which all have somewhat similar molecules) - the H2 blockers. Prilosec and the other proton pump inhibitors also block the release of stomach acid, but they are in a different class with a different molecular structure. One class may enter the brain (cross the blood-brain barrier) more easily and exert effects there - I haven't looked at the two classes for their different properties in this respect, though.
In short, they are very different drugs with the same beneficial effect.
Bob G.

[Bala]

Taking prilosec and other PPIs gives me headache after continous use for say 25 days....is it related to cognitive impairment..?

[reflux man]

in emergency ....PPI is the first solution, but change lifestyle, good diet and avoid streess is best solution for heartburn