Colchicine: Risky for Long-Term Brain Health?

I take colchicine .6-1.2mg/day for Behçet’s and know many of you do for cardiac protection as well.

My concern is whether colchicine, a known neurotoxin, is actually a risky drug with respect to long-term effects on the brain.

As I understand, colchicine is a neurotoxin which induces Alzheimer’s in rats when injected into the brain. This is uncontested and the subject of many papers. However, we assume that it does not cross the blood-brain barrier because in overdoses from systemic exposure, death occurs from organ failure not direct CNS poisoning. However, from what I can tell, there is precious little actual evidence that colchicine definitely does not cross the BBB, OR that the limited extent it does, even if negligible in an overdose event, could cause cognitive effects over long-term usage (consider daily usage over 50-70 years) or even lead to Alzheimer’s later on.

What do we think of this: safe for daily use over years and decades, or questionable if your main priority above all else is neurological health and brainspan?

Is a specialist prescribing this to you? If so, they will likely know more about the drug than anyone here.

Colchicine is risky for several reasons, the least of which is that it’s an anticholinergic (which could contribute to AD).

I can think of better, much safer things for cardio protection.

After our systematic review, we selected 125 low potency (Score 1) anticholinergic drugs (Table 1), 28 drugs with medium potency (Table 2) and 62 drugs with high anticholinergic potency (Table 3). Of these, colchicine was ruled out, as one author rated this drug with a score of 1 or 3 [46], another scale rated it as discrepant (Disc) and two scales explicitly rated it with a null anticholinergic score [42,48].

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Yes, a specialist prescribed it, and no, they do not have the answer to this (nor does anybody else definitively) which is why I am asking here.

I am not taking it for cardio protection and that is not what my question is about.

This is where I found different information (note that it is from this year):

Colchicine is on the 2nd list - not a powerful anticholinergic, but still listed.