Research Reveals Possible Mechanism for Proton Pump Inhibitors – Dementia Link

Published on May 13, 2020 by Sandy Liebhard

A new study out of Sweden has revealed how the long-term use of Nexium and other proton pump inhibitors might increase an individual’s risk for dementia.

Heartburn Drugs Inhibit Production of Vital Neurotransmitter

Seven previous studies involving proton pump inhibitors have already pointed to a link between extended use and dementia. This new study indicates the drugs might inhibit the production of acetylcholine, a vital neurotransmitter that ensures signals pass between cells, but is also known to play a significant role in the development of Alzheimer’s disease and other dementia-related conditions

The authors of the study used 3D computer simulations to examine how six different proton pump inhibitors interacted with choline acetyltransferase, an enzyme that synthesizes acetylcholine. The simulations suggested that the drugs did bind with choline acetyltransferase, inhibiting its actions and resulting in reduced production of acetylcholine. Omeprazole (Prilosec), esomeprazole (Nexium), rabeprazole (AciPhex) were among the proton pump inhibitors that appeared to have strongest effect, while pantoprazole (Protonix) and lansoprazole (PrevAcid) had the weakest.

While additional research is needed to confirm the results of this lab investigation, the study’s lead author is cautioning against proton pump inhibitor overuse.

“Special care should be taken with the more elderly patients and those already diagnosed with dementia,” Taher Darreh-Shori, senior researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, said in a statement announcing the findings. “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.”

Side Effects of Long-Term Proton Pump Inhibitor Use

Millions of people around the world rely on proton pump inhibitors like Nexium, Prilosec, and PrevAcid to control heartburn and other problems associated with the excess production of stomach acid. But while they’re only indicated for short-term use, studies have shown that a significant percentage of patients take the drugs far longer than recommended or for inappropriate indications.

In addition to dementia, previous studies have linked long-term use of proton pump inhibitors to a range of other serious health consequences, including:

• Heart attacks
• Fractures
• Vitamin B deficiency
• Low magnesium levels
• Gastric cancer

Other research suggests extended treatment with Nexium or similar drugs may contribute to the development of chronic kidney disease, kidney failure, and other renal complications.

More than 13,400 proton pump inhibitor lawsuits are currently pending in a multidistrict litigation underway in the U.S. District Court, District of New Jersey. The majority of plaintiffs allege that their long-term use of Nexium, Prilosec, PrevAcid, Protonix, and Dexilant resulted in kidney failure and other serious renal problems. They further claim that the drugs’ manufacturers have long known that their products could harm the kidneys, but endeavored to conceal evidence of these side effects and failed to provide doctors and patients with appropriate safety warnings.

The first bellwether trial of a proton pump inhibitor lawsuit is scheduled to be convened in November 2021.