Antidepressants Might Accelerate Dementia Decline
By Dennis Thompson HealthDay Reporter
TUESDAY, Feb. 25, 2025 (HealthDay news) -- Antidepressants are frequently prescribed to people with dementia for symptoms like anxiety, depression, aggressiveness and sleeplessness.
But a specific class of antidepressant medications -- selective serotonin reuptake inhibitors (SSRIs) -- actually might speed up brain decline among some dementia patients, a new Swedish study suggests.
Heavier doses of certain SSRIs are tied to a higher risk for severe dementia, researchers reported in a new study published Feb. 24 in the journal BMC Medicine.
Taking more than the average amount typically prescribed for these drugs was linked to an additional decline of 0.42 points per year in a dementia scale that runs from 0 to 30, researchers found.
The SSRI drug escitalopram was associated with the fastest cognitive decline, followed by citalopram and sertraline.
Mirtazapine, which works in a different way, had less negative impact on brain function, researchers found.
“Depressive symptoms can both worsen cognitive decline and impair quality of life, so it is important to treat them,” said senior investigator Sara Garcia Ptacek, an assistant professor of neurology at the Karolinska Institute in Solna, Sweden.
“Our results can help doctors and other healthcare professionals choose antidepressants that are better adapted for patients with dementia,” she added in a news release.
For the study, researchers tracked the brain health of more than 18,700 patients enlisted in the Swedish Registry for Cognitive/Dementia Disorders between May 2007 and Oct. 2018. The patients’ average age was 78.
During an average follow-up of more than four years, about 23% of patients received a new prescription for an antidepressant, researchers said.
SSRIs were the most commonly prescribed antidepressant, amounting to 65% of all those prescriptions, the study says.
“Higher dispensed doses of SSRIs were associated with higher risk for severe dementia, fractures, and all-cause mortality,” the researchers concluded. “These findings highlight the significance of careful and regular monitoring to assess the risks and benefits of different antidepressants use in patients with dementia.”
Faster rates of brain decline were observed among men taking antidepressants compared to women, results also show.
However, outside experts warn that caution should be exercised when interpreting these results.
“There are some important limitations that should be considered,” Dr. Prasad Nishtala, a reader in life sciences with the University of Bath in the U.K., said in a news release.
“One major issue is that the severity of depression in dementia patients wasn't fully accounted for, which has the potential to bias the results,” said Nishtala, who reviewed the findings. “Additionally, there may be a ‘channelling bias,’ meaning that certain antidepressants like citalopram and sertraline might have been more commonly prescribed to patients with severe dementia, which could also bias the results.”
He added that the study suggests that SSRIs like citalopram and sertraline might also speed up cognitive decline.
"However, it doesn’t explain how or why this happens at a biological level,” Nishtala added. “Because of these limitations, the study's findings should be interpreted with caution and ideally replicated using other real-world data sources.”
Sources
- Springer, news release, Feb. 24, 2025
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.
Posted February 2025
Read this next
Most Americans Want Easy Early Testing For Alzheimer's
WEDNESDAY, April 30, 2025 -- Most Americans want to know if they’re destined to lose their brain power to Alzheimer’s disease, according to an annual report produced...
Sexual Assault Triples Suicide Risk Among Veterans
WEDNESDAY, April 30, 2025 -- Sexual assault and sexual harassment during military service dramatically increases veterans’ risk of suicide later in life, a new study...
No Greater Risk Of Brain Aging Among People With Autism
TUESDAY, April 29, 2025 -- People with autism do not appear to be at greater risk of age-related brain decline, a new study says. Older people with autistic traits have no...
More news resources
- FDA Medwatch Drug Alerts
- Daily MedNews
- News for Health Professionals
- New Drug Approvals
- New Drug Applications
- Drug Shortages
- Clinical Trial Results
- Generic Drug Approvals
Subscribe to our newsletter
Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.