New Findings Suggest Antidepressants Speed Up Dementia
Antidepressants are often prescribed to individuals with dementia to manage symptoms like anxiety, depression, aggression, and sleeplessness. However, a new Swedish study suggests that selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants, may accelerate cognitive decline in some dementia patients.
The study, published in BMC Medicine on Feb. 24, found that higher doses of SSRIs were associated with a greater risk of severe dementia. Patients taking doses above the average amount prescribed experienced an additional yearly decline of 0.42 points on a dementia severity scale, which ranges from 0 to 30. The SSRI drugs linked to the fastest cognitive decline were escitalopram, followed by citalopram and sertraline. Mirtazapine, an antidepressant that works differently, was found to have less impact on brain function.
Senior investigator Sara Garcia Ptacek, from the Karolinska Institute, emphasized the importance of treating depressive symptoms in dementia patients while considering the potential negative effects of certain antidepressants. The study tracked over 18,700 patients from the Swedish Registry for Cognitive/Dementia Disorders, with an average age of 78, over a period of more than four years. About 23% of the patients received a new antidepressant prescription, with SSRIs making up 65% of those prescriptions.
The study concluded that higher doses of SSRIs were linked to more severe dementia, fractures, and higher mortality rates. The findings also indicated that men on antidepressants experienced faster cognitive decline than women. However, outside experts, such as Dr. Prasad Nishtala from the University of Bath, cautioned against drawing definitive conclusions, noting potential limitations like unaccounted severity of depression and the possibility of certain antidepressants being more commonly prescribed to those with severe dementia. He stressed that further research is needed to understand the biological mechanisms behind the observed cognitive decline.
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