How can proton pump inhibitors damage central and peripheral nervous systems?

Proton-pump inhibitors(PPIs)are first line therapy for most gastroesophageal acid-related disorders.They include reflux disorders,Helicobacter pylori infections,Zollinger-Ellison syndrome,and gastroesophageal malignancies.In clinical practice,PPIs have largely replaced histamine-2 receptor antagonists(H2RAs)due to their superior efficacy and are currently widely prescribed and sold worldwide.(Kantor et al.,2015).Since the PPIs are,in addition,freely available without prescription in the United States,there has been a growing concern over proton-pump inhibitor prolonged use and serious side effects such as Alzheimer’s disease(AD)type dementia.A few large scale studies have shown an increased risk of the AD type and non-AD type dementia with PPI use,while others have questioned this association(Novotny et al.,2018;Khan et al.,2020).