Antidepressants are often prescribed to dementia patients to relieve symptoms such as anxiety, depression, aggressiveness and sleep disorders. However, a Swedish study published in BMC Medicine finds that a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can speed up cognitive decline in dementia patients.
The findings were based on data from 18,740 patients with an average age of 78. Nearly 23 per cent of the patients were treated with antidepressants during 4.3 years of follow-up, and 65 per cent received SSRIs.
Compared to patients who did not take antidepressants, taking SSRIs was associated with greater cognitive decline and higher risks of severe dementia, all-cause mortality and fractures. Higher doses of SSRIs were tied to an increased risk of severe dementia. Additionally, men who took antidepressants showed faster rates of cognitive decline compared to women.
The SSRI drug escitalopram was associated with the fastest cognitive decline, followed by the SSRIs citalopram and sertraline. Mirtazapine, an antidepressant with a different mechanism of action, had a less pronounced negative impact on cognition than escitalopram.
“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 health care professionals choose antidepressants that are better adapted for patients with dementia,” the lead researcher said.
