Antidepressants may accelerate memory loss in older adults with dementia, a major Swedish study has revealed.
Research from the Karolinska Institute found that patients taking selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed type of antidepressant, experienced a faster decline in their brain function.
Nearly nine million people in England take antidepressants, with more than half using SSRIs such as sertraline and citalopram, which are the NHS’s first-choice medicines for anxiety and depression.
The study followed 18,700 adults with an average age of 78, all newly diagnosed with dementia, over a 10-year period.
Patients taking SSRIs experienced a faster decline in brain function
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Nearly a quarter of the patients were prescribed antidepressants during the study period.
Researchers compared the results of regular memory tests between those taking antidepressants and those who were not.
The findings showed patients taking SSRIs experienced a faster decline in brain function, measured by the mini-mental state examination which tests ability to recall information like dates and word lists.
Scores on the 30-point test decreased by an additional 0.42 points per year in those taking antidepressants.
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The research also revealed that patients on antidepressants faced higher risks of fractures and were more likely to die of any cause.
Writing in the journal BMC Medicine, researchers noted that while “antidepressants were associated with increased cognitive decline”, the study could not prove cause and effect.
Depression itself, rather than the medication, might be responsible for accelerating memory loss.
Study author Sara Garcia-Ptacek said: “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 healthcare professionals choose antidepressants that are better adapted for patients with dementia.”
Depression itself, rather than the medication, might be responsible for accelerating memory loss
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Richard Oakley from the Alzheimer’s Society said further research was needed, noting that the study “did not rule out the possibility that the changes were due to the presence of depression rather than antidepressant use”.
He stressed the importance of regular medication reviews, revealing that “less than half of people with a dementia diagnosis had their medication reviewed in the preceding 12 months”.
Professor Tara Spires-Jones of the UK Dementia Research Institute added that patients needing antidepressants may have had “more aggressive disease”, noting that previous studies showed mixed results.
Dr Prasad Nishtala, a reader at the University of Bath, urged caution in interpreting the findings.
“This 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,” he said.
He added that due to these limitations, the study’s findings “should be interpreted with caution and ideally replicated using other real-world data sources”.