Dementia is commonly linked to a severe loss of memory and cognitive function. It often comes with a variety of psychiatric symptoms, such as anxiety, sleep loss, and depression.
A recent population-based study conducted by researchers at the Karolinska Institute in Sweden has uncovered that a common first-line class of antidepressants prescribed to dementia patients for depression might accelerate their cognitive decline. It also suggests that these medications could increase the risk of fractures and lead to earlier mortality.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are often the first choice due to their relatively few side effects. However, recent research indicates a potential link between these inhibitors and an increased risk of dementia in older adults, especially when compared to psychotherapy.
While SSRIs are generally believed to protect the brain from neurodegeneration and even reduce plaques that damage brain cells, their potential to interfere with cognitive processes such as thinking and memory recall is not entirely surprising.
Neurobiologist Minjia Mo and colleagues from the Karolinska Institute analyzed medical data from a Swedish register, comprising 18,740 newly diagnosed dementia patients from 2007 to 2018. Over 20 percent of these patients were prescribed at least one antidepressant, with nearly two-thirds receiving an SSRI.
The study revealed a clear association between SSRI medication and severe dementia. Patients on more than a standard daily dose experienced an increase of nearly half a point in dementia assessment scores annually.
Given the observational nature of this study, other factors could influence these findings, complicating the ability to definitively link antidepressant doses to cognitive decline. The pre-existing cognitive decline in patients also adds complexity to the analysis.
The researchers noted a concerning increase in fracture risk linked to higher SSRI doses, suggesting potential unwanted neurological effects. The study also hinted at an increased risk of all-cause mortality. Interestingly, no such link was found with SNRIs, suggesting potential differences in their mechanisms or study limitations.
It is crucial to emphasize that any changes to medication should only occur in consultation with a healthcare professional. Physicians and dementia care specialists consider various risks and benefits when prescribing and adjusting treatment plans for individual patients.
Tailoring medication combinations and dosages to a patient's overall prognosis is essential, making studies like this vital for finding the right balance in alleviating the distress associated with cognitive decline.
