New research has revealed that antidepressants may accelerate cognitive decline in individuals suffering from dementia. However, some medications appear to be less detrimental than others, offering valuable insights that could aid doctors in making informed treatment decisions. These findings are detailed in the paper, "Antidepressant use and cognitive decline in patients with dementia: a national cohort study," published in BMC Medicine.
Antidepressants are commonly prescribed to alleviate symptoms such as anxiety, depression, aggressiveness, and sleep disturbances in dementia patients. However, a recent observational study utilizing data from the Swedish Dementia Registry (SveDem) suggests that dementia patients treated with these medications experience an increased rate of cognitive decline compared to those not receiving such treatment.
The study analyzed registry data from 18,740 patients, with approximately 23% of them being treated with antidepressants. Over the study period, 11,912 antidepressant prescriptions were recorded, with selective serotonin reuptake inhibitors (SSRIs) comprising 65% of these prescriptions.
According to Sara Garcia Ptacek, a researcher at the Department of Neurobiology, Care Sciences, and Society at Karolinska Institutet, and the study's last author, depressive symptoms can exacerbate cognitive decline and adversely affect quality of life. Therefore, it is crucial to treat these symptoms effectively. The study's findings can assist healthcare professionals in selecting antidepressants that are better suited for dementia patients.
Conducted by researchers from Karolinska Institutet and Sahlgrenska University Hospital in Gothenburg, the study monitored patients' cognitive progression over time, comparing both medicated and non-medicated groups, as well as different types of antidepressants.
The study also highlights differences between various antidepressants. The SSRI escitalopram was linked to the most rapid cognitive decline, followed by citalopram and sertraline. On the other hand, mirtazapine, which operates through a different mechanism, was found to have a less significant negative impact on cognition compared to escitalopram.
The researchers aim to explore whether specific patient groups, such as those with certain dementia types or biomarkers, exhibit different responses to various antidepressants. "The goal is to identify these subgroups to provide more individualized care," says Ptacek.
