Do medications cause confusion at times and if so which ones are able to do so?
Answer
As therapists, we need to start looking at the medications and their side effects to see if they are possibly having confusion side effects. This may be the problem the patient is having all along. Antidepressants cause confusion. Opioid analgesics cause confusion. Drugs with anticholinergic effects also cause confusion. Certain medications become toxic in the blood. They have a very long half-life and they have to be monitored with blood work to make sure that the medicine is not going to a toxic level. Two medications in particular that cause problems related to toxicity are lithium and digoxin. This is one reason why you see these medicines being prescribed less often than they used to be. As far as lithium goes, they have other antipsychotic medications that do not have the same toxicity. Digoxin is a heart pill and it is prescribed less than it used to be, because we are catching heart failure at an earlier stage and therefore is able to be treated with diuretics. Worsening of confusion for people with mild cognitive impairment can also occur with specific medications. Be aware of this as you are treating your patients. See what they are taking, and if you are not sure if what they are taking is causing this, I recommend downloading a free app called WebMD to put on your iPhone or android device. With this app, you can look up any medication and it will tell you the indications for use, all the side effects, and it will have pictures of the medications inorder to determine generic pills over name brands.
Kenneth L. Miller, PT, DPT, GCS, CEEAA
Dr. Ken Miller, PT, DPT, is a board-certified geriatric clinical specialist and advanced credentialed exercise expert for aging adults. Dr. Miller is an assistant professor at the Medical University of South Carolina in the Division of Physical Therapy and serves as the founding director of the USC Geriatric Residency Program. His clinical focus is on best practices for use with the older adult population. Dr. Miller is the Director overseeing Practice for the Academy of Geriatric Physical Therapy. He has spoken nationally and internationally on topics of gerontology, including pharmacology, primary prevention, frailty, outcome measures, best practices, and pain management for the older adult. Dr. Miller has over 20 years of clinical expertise in risk mitigation and error prevention and is currently researching well-being, mental health, and burnout in physical therapists.
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