Swedish researchers uncover troubling links between antidepressants and increased cognitive decline in dementia patients.
Quick Takes
- Study shows antidepressants may worsen cognitive decline in dementia patients.
- Escitalopram linked to the fastest cognitive decline among SSRIs.
- Researchers suggest reassessment of antidepressant prescriptions in dementia care.
- The study highlights the need for personalized treatment plans.
Study Reveals Antidepressant Risks
Research by the Karolinska Institutet and Sahlgrenska University Hospital analyzed data from the Swedish Dementia Registry (SveDem) involving 18,740 dementia patients. Findings indicate that patients on antidepressants, primarily SSRIs, experienced a notably faster cognitive decline compared to those not taking these medications. Approximately 23% of the patients were prescribed antidepressants to manage symptoms such as anxiety, depression, and aggressiveness, with SSRI usage at 65% among them.
The study noted that escitalopram, followed by citalopram and sertraline, was associated with the most rapid decline. Conversely, mirtazapine appeared to have a less negative impact on cognitive function. While these results hold significant implications for dementia care, questions remain as to whether cognitive impairment is directly caused by the drugs or by the underlying depressive symptoms.
Prescriptions of selective serotonin reuptake inhibitors (SSRIs) — a class of antidepressants — are associated with faster rates of cognitive decline in patients with dementia, according to research published in @BMCMedicine: https://t.co/pDYwpcl01z
— Springer Nature (@SpringerNature) February 25, 2025
Implications for Medical Practice
The findings call for medical professionals to reconsider the prevalent prescription of antidepressants for dementia patients. As many as half of dementia sufferers experience depression, which complicates their care regimen. Researchers stress the importance of tailoring treatment to mitigate cognitive risks while still addressing mental health needs effectively. This involves a nuanced approach to selecting antidepressants and potentially adopting non-pharmaceutical methods.
“Depressive symptoms can both worsen cognitive decline and impair quality of life, so it is important to treat them. Our results can help doctors and other healthcare professionals choose antidepressants that are better adapted for patients with dementia.” – Sara Garcia Ptacek
The analysis also demonstrated that men taking antidepressants experienced faster cognitive decline compared to women. The information underscores the necessity for ongoing research to better understand antidepressant impacts and identify potentially safer options.
New research suggests that antidepressants can accelerate cognitive decline in people with dementia. At the same time, some drugs appear to be less harmful than others, which can help doctors make better treatment decisionshttps://t.co/z9j1HosxYN pic.twitter.com/FJJYXCrq0W
— Top Biomedical Science (@imedverse) February 25, 2025
Moving Toward Evidence-Based Dementia Care
Despite the study’s significant findings, experts caution against abrupt changes in clinical practice without further corroboration. A 2019 review noted the limited efficacy of antidepressants for treating depression in Alzheimer’s patients. Future investigations aim to identify patient subgroups who might benefit most from alternative care strategies.
“There are some important limitations that should be considered. One major issue is that the severity of depression in dementia patients wasn’t fully accounted for, which has the potential to bias the results.” – Prasad Nishtala
Ultimately, the need for more comprehensive studies is emphasized, ideally leading to more effective and safer treatments for dementia-related mental health issues without accelerating cognitive decline.
Sources
1. Study explores link between antidepressant use and cognitive decline in dementia patients
2. Antidepressants may be worsening dementia — why doctors will still prescribe them
