Many people living with dementia also struggle with depression, anxiety, sleep problems, or changes in behavior. To help with these symptoms, doctors often prescribe antidepressant medicines.
These drugs are widely used and can improve mood and quality of life for many patients. However, a new study suggests that some of these medications may have an unexpected downside for people with dementia.
Researchers used data from a large national database in Sweden called the Swedish Dementia Registry, also known as SveDem. This database collects health information from people diagnosed with dementia across the country. By studying this data, scientists were able to look at how different treatments affect patients over time.
The study included 18,740 people with dementia. Among them, about 23 percent were taking antidepressants. Over the course of the study, doctors prescribed more than 11,000 antidepressant treatments.
The most commonly used type was a group of drugs called selective serotonin reuptake inhibitors, often known as SSRIs. These drugs made up about 65 percent of all prescriptions.
SSRIs are commonly used because they are generally considered safe and effective for treating depression. They work by increasing the levels of a chemical in the brain called serotonin, which helps improve mood. Some of the most commonly used SSRIs in this study included escitalopram, citalopram, and sertraline.
The researchers followed the patients over time and compared those who took antidepressants with those who did not. They looked at how quickly the patients’ thinking and memory skills changed.
The results showed a clear pattern. People with dementia who were taking antidepressants tended to experience faster decline in memory and thinking compared to those who were not taking these drugs.
It is important to understand that this study does not prove that antidepressants directly cause faster mental decline. The research only shows a link between the two. There could be other reasons for the difference.
For example, people who are prescribed antidepressants may already have more severe symptoms or more advanced disease. Depression itself may also contribute to worsening memory and thinking problems.
Even so, the findings raise important questions about how these medications are used in people with dementia. The study also found that not all antidepressants had the same effect. Some appeared to be more strongly linked to faster decline than others.
Among the SSRIs, escitalopram was linked to the fastest decline in thinking ability. Citalopram and sertraline were also associated with noticeable decline, although to a slightly lesser degree.
In contrast, another type of antidepressant called mirtazapine seemed to have a smaller impact on memory and thinking. This drug works in a different way from SSRIs and may be a safer option for some patients.
One of the researchers, Dr. Sara Garcia Ptacek from Karolinska Institutet, explained that treating depression in dementia patients is still very important. Depression can make symptoms of dementia worse and reduce quality of life. However, this study suggests that doctors need to be more careful when choosing which antidepressant to use.
The researchers plan to continue studying this issue. They want to understand whether certain groups of patients are more sensitive to specific medications. For example, different types of dementia may respond differently to treatment. By learning more, doctors may be able to create more personalized treatment plans.
For now, the study highlights the importance of balancing the benefits and risks of antidepressant use in dementia. It does not mean that patients should stop taking their medication. Instead, it suggests that treatment decisions should be made carefully, with close monitoring and regular review.
This research was published in the journal BMC Medicine. It adds to growing evidence that even commonly used medicines can have complex effects, especially in older adults with conditions like dementia.
In the end, the goal is to help patients feel better while protecting their brain health as much as possible. With more research, doctors can make better choices and provide safer, more effective care for people living with dementia.
If you care about dementia, please read studies about dietary strategies to ward off dementia, and how omega-3 fatty acids fuel your mind.
For more health information, please see recent studies about Choline deficiency linked to Alzheimer’s disease, and what to eat (and avoid) for dementia prevention.
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