Nexium and increased dementia risk

nexiumI’ve previously posted that Nexium and similar acid-reducing drugs, the PPIs (proton pump inhibitors), have been linked to an increased risk of heart attack .

Now, a new study has confirmed a connection between PPIs and dementia.

The patients receiving regular PPI medication…had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication…

The avoidance of PPI medication may prevent the development of dementia.

The study specifically looked at PPI use in patients age 75 and older, who are frequently taking several prescription medications.

This is an important study, because as the health news website Medscape reports:

PPIs are among the most frequently prescribed drugs and their use has been increasing sharply, especially among the elderly.

“Unfortunately, overprescribing of PPIs is reported frequently,” said study coauthor Britta Haenisch, PhD, also from the German Center for Neurodegenerative Diseases.

According to some research, up to 70% of all PPI prescriptions could be inappropriate, she toldMedscape Medical News.

“In general, clinicians should follow guidelines for PPI prescription to avoid overprescribing PPIs and inappropriate use.”

However, this study is observational only and does not prove PPIs cause dementia, only that there appears to be a connection. More studies need to be done.

Until then, the long-term harmful effects of PPIs are not known, so Nexium and similar drugs should be used with caution and a clear understanding of risks and benefits.

The most commonly prescribed PPIs are Nexium (aka “The Purple Pill” or esomeprazole), Prilosec (omeprazole), and Prevacid (lansoprazole).

They are used to treat a variety of gastrointestinal diseases, such as GERD and peptic ulcers.

Not only are these drugs heavily marketed to a wide audience via television and the internet, but they are all available over-the-counter without a prescription.

So even if physicians can be counseled to write fewer prescriptions for Nexium, many patients could still be overusing these drugs.

In my experience, over-the-counter drugs are frequently misused and overused as there is a (false) assumption that if a drug can be bought at the drug store it must be safe.

Not true!

Before using any over-the-counter medication, first make sure it is the right drug for what you need and then read the label to determine:

  • the correct dose for your age and weight;
  • the maximum dose that can be taken over a 24-hour period;
  • whether you have a condition that makes the drug unsafe, such as being pregnant;
  • whether the drug should be taken with or without food;
  • whether alcohol, other foods, or other drugs should be avoided;
  • what are the possible side effects, such as drowsiness, upset stomach, etc.
  • the recommended length of treatment. For example, the label on the over-the-counter version of Nexium says “Do not use for more than 14 days unless directed by your doctor.”

Generic PPIs that are available over the counter might be cheaper than a prescription, and that could be helpful to patients without insurance.

Related post: Nexium – Brand, generic, prescription or OTC

But I wouldn’t recommend self-diagnosing and treating yourself with a PPI. Talk to your health care provider first and ask if there are lifestyle changes you can try before turning to a prescription drug.

After discussing risks and benefits, you and your care provider might decide a PPI is the best course of action.

And the best advice for patients of any age, regarding any prescription, is to take the lowest effective dose of a drug for the shortest time possible.

By the way, I’m picking on Nexium because, hey, they want to be known as the best-selling, most frequently prescribed PPI. So I think they should take some of the bad press, as well.


Frugal Nurse



Nexium and increased dementia risk — 6 Comments

  1. These drugs are bad for you so what can I take for my stomach that won’t I hurt me

    • Hi Brenda, I don’t know what kind of stomach problems you are having. The best therapy would depend on what’s causing your symptoms. Some stomach problems really respond well to diet modifications and other lifestyle changes. Others might require medication. Talk to your health care provider. If a medication is recommended, just be informed about both the benefits and the side effects, so you know what you’re getting. And don’t take it any longer than necessary. Best, FN

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  2. my husband William H Miller has been on nexium for years now and has been diagnosed with dementia

    • I am very sorry to hear about your husband’s diagnosis. It’s not possible to say Nexium contributed to his dementia; much more research needs to be done to explore that connection. This recent study, however, certainly cautions us–providers and patients–to use PPIs (all drugs, really) with more thought to long-term harms. We just don’t know enough about using these long-term, or how they interact with all the other prescription medications people are taking these days. Take care, FN