New Study: This Popular Drug Sped Up Dementia Decline

One in 10 Americans have found some relief from depression and anxiety through antidepressants—but that means at least some have experienced the annoying side effects that go along with it. And while patients may be used to risks like an upset stomach, headaches, drowsiness, and sexual dysfunction, as highlighted by the Cleveland Clinic, they may now have to accept another possibility: cognitive decline.

A study published in BMC Medicine in February sought to determine whether there is a link between antidepressants and declining cognition. A team of 12 neuroscientists in Sweden used the Swedish Dementia Registry (SveDem) to review data for over 18,700 patients with recently diagnosed dementia, including those with Alzheimer’s and mixed dementia. Nearly 23% of the subjects (4,271 people) received at least one prescription for an antidepressant, and all were new users who had not previously taken an antidepressant before.

Reviewing data collected between 2007 and 2018, the researchers found that those who took an antidepressant experienced faster cognitive decline than those who did not. This was especially the case for subjects who had severe dementia, and also those taking higher doses of an antidepressant.

Though multiple types of antidepressants were studied, most were selective serotonin reuptake inhibitors (SSRIs). The Mayo Clinic notes that SSRIs are the most commonly prescribed antidepressants, and they’re considered safe with fewer side effects than other antidepressants.

Three types of SSRIs were associated with faster cognitive decline in dementia patients:

• Escitalopram (Lexapro)
• Citalopram (Celexa)
• Sertraline (Zoloft)

Notably, Mirtazapine, a tetracyclic antidepressant, was linked to faster decline as well.

The study also found that men taking antidepressants experienced faster cognitive decline than women, and patients taking antidepressants were more likely to experience fractures and had a greater risk of mortality.

However, the scientists note that more research is needed, as they have considered the possibility that depression itself could be linked to faster cognitive decline rather than antidepressants. There is demonstrated evidence of a link between depression and dementia. For example, a 2023 study published in JAMA Neurology found that “the risk of dementia was more than doubled for both men and women with diagnosed depression.” This appeared to be true no matter what stage of adulthood depression had been diagnosed.

The BMC Medicine researchers also noted that “antidepressants do not seem to work as well in patients with dementia, possibly because ‘depression in dementia is a different illness’ than depression in people with intact cognition.”

The study’s lead author, Sara Garcia-Ptacek, MD, PhD, commented to MedPage Today: “In the future, I hope to see much more targeted prescription, where drugs are adapted better to specific patients.”

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• Can You Ever Stop Taking Antidepressants?
• 8 Signs You Could Have High-Functioning Depression
• 50 Everyday Habits That Reduce Your Risk of Dementia
• How High Is Your Alzheimer’s Risk? Doctors Say This 3-Minute Test May Reveal Your Chances of Dementia and Stroke