Antidepressants are commonly used in patients with dementia to improve symptoms including anxiety, depression, aggression, and sleep disorders. How they affect cognitive function in dementia, however, remains understudied. The researchers behind the current study thus investigated the link between antidepressants and cognitive decline in patients with dementia.
To do so, they analyzed healthcare data from Sweden including 18, 740 patients with dementia, of whom 22.8% received at least one prescription for an antidepressant. Over the course of the study, 11, 912 prescriptions for antidepressants were registered, the majority of them- 65%- being selective serotonin reuptake inhibitors (SSRIs).
Ultimately, antidepressants were associated with faster cognitive decline, with SSRI escitalopram linked to the fastest cognitive decline, followed by SSRIs citalopram and sertraline, when compared to non-use. Mirtazapine, which is not an SSRI, had a smaller impact on cognitive decline.
The researchers further found that higher dispensed doses of SSRIs were linked to a higher risk for severe dementia, fractures, and all-cause mortality.
While the study doesn't necessarily indicate causation, the findings do suggest a correlation between the use of antidepressants and cognitive decline.
"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," said study author, Sara Garcia Ptacek, a researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden, in a press release.
The researchers now intend to investigate how different patient groups with specific dementia types or biomarkers respond to different antidepressants.
"The goal is to find these subgroups to create more individualised care,” said Garcia Ptacek.
Sources: EurekAlert, BMC Medicine
