The Danger of the Purple Pill

August 1, 2016

 

 

Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis

JAMA Neurol 2016 Feb 15;[EPub Ahead of Print], W Gomm, K von Holt, F Thomé, K Broich, W Maier, A Fink, G Doblhammer, B Haenisch

The authors of this prospective, German cohort study used observational data from 2004 to 2011 from 73,690 participants and evaluated the association between PPI (ie, esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole) use and incident of dementia. After adjusting for potential confounding variables, patients receiving PPI therapy had a significantly increased risk of incident dementia.

Proton pump inhibitors (PPIs) are used by many patients and have recently been linked to potential harms: malabsorption of vitamins and minerals, heart disease, arrhythmia ( irregular heart rate), kidney failure , osteoporosis, fractures and bacterial overgrowth.
They are also associated with the risk for pneumonia, travelers diarrhea, and other more dangerous infections, like C.difficile.

PPIs are one of the most popular classes of drugs prescribed. 
An estimated 15 million Americans use PPIs, which are sold by prescription and over the counter under a variety of brand names, including Nexium, Prilosec and Prevacid. There were 114 million prescriptions written for them in 2009 before most of them became available OTC. Americans spent $5.1 billion on Nexium in 1 year, the most popular PPI, alone.

It is time to step back and ask whether we've been reaching for that PPI bottle too often and too soon. Occasional heartburn can be treated effectively with the old-fashioned antacids, like Tums or DGL . Some people find that only certain foods (chocolate, coffee, fatty food) trigger acid reflux, so they need to learn to avoid them.
A chewing gum habit increases the production of saliva that can soothe an irritated esophagus and wash stomach acid back down into the stomach. And if the problem is nighttime heartburn, not eating heavy meal too late at night, elevating the head of the bed can help.

To receive more information on how to wean yourself off PPIs and other health related advice please contact Dr. Kogansk.

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