| Keywords [eng] |
neurotoxicity, drug-induced neurotoxicity, everyday medications, adverse drug reactions, oxidative stress, mitochondrial dysfunction, blood-brain barrier, pharmacovigilance, cognitive impairment, pharmacogenomics, central nervous system, polypharmacy, proton pump inhibitors, SSRIs, beta-blockers, fluoroquinolones, statins, chemotherapy, personalized medicine, medication safety |
| Abstract [eng] |
Medications are fundamental to modern healthcare, significantly improving patient outcomes across a wide range of conditions. However, increasing evidence shows that many commonly prescribed drugs can have unintended neurotoxic effects, potentially impacting cognition, emotions and the integrity of our nervous systems. Despite their therapeutic benefits, these adverse effects are often underrecognized or misattributed, particularly in older adults or patients with complex comorbidities. The aim of this literature review is to evaluate the neurotoxic potential of commonly prescribed medications and raise physician awareness to promote safer prescribing practices. A systematic review of the literature was conducted using databases such as PubMed, ScienceDirect, and Google Scholar, with a focus on peer-reviewed articles published in the last two decades. Included sources ranged from clinical trials and observational cohort studies to case reports and mechanistic research involving in vitro and animal models. Neurotoxicity was assessed based on mechanisms such as oxidative stress, mitochondrial dysfunction, neurotransmitter imbalances, excitotoxicity, neuroinflammation, ion channel disruption, and alterations to the blood-brain barrier. Additional risk factors considered included polypharmacy, age, genetic polymorphisms (e.g., Cytochrome variants, alleles), comorbid conditions, and nutrient deficiencies. The results highlight that cardiovascular drugs such as statins and beta-blockers are associated with memory loss, mood changes, and in some cases, suspected links to neurodegenerative conditions. Proton pump inhibitors are linked to memory impairment through pathways involving vitamin B12 deficiency and gut microbiome disruption. Psychiatric medications, including selective serotonin reuptake inhibitors and benzodiazepines, are implicated in serotonin syndrome, long-term dependence, and impaired cognition. Antiepileptic drugs have been found to contribute to sedation, cognitive slowing, and developmental risks in certain populations. Fluoroquinolone antibiotics are associated with mitochondrial toxicity, peripheral neuropathy, and seizures. Chemotherapy agents, particularly platinum compounds and taxanes, are strongly linked to chemotherapy-induced peripheral neuropathy and cognitive impairment, commonly referred to as “chemo brain.” In conclusion, neurotoxicity from widely used medications presents a significant clinical concern. Greater emphasis should be placed on early detection, patient-specific risk stratification, and integration of pharmacogenomic data to reduce neurotoxic risks. Personalized prescribing, combined with better education on neurotoxic side effects, can help minimize harm. Further research is essential to clarify the underlying mechanisms, identify at-risk populations, and develop neuroprotective strategies to support long-term neurological health in patients requiring chronic pharmacotherapy. |
