Can Antidepressants Cause Dementia?

New research from Karolinska Institutet suggests that the use of certain antidepressant medications may be linked to faster cognitive decline in individuals with dementia. The findings, published in BMC Medicine [1], are based on data from nearly 19,000 patients and raise important questions about how depression and anxiety should be treated in people with dementia.

About the Study

The study included 18,740 individuals diagnosed with dementia, enrolled in the Swedish Dementia Registry (SveDem) between 2007 and 2018. Researchers examined the relationship between antidepressant use and changes in cognitive function over time, measured using the Mini-Mental State Examination (MMSE), a standard cognitive test.

Patients were followed for up to seven years. The analysis adjusted for several factors, including age, sex, type of dementia, medication use, and baseline disease severity.

Which Antidepressants Had the Most Impact?

The results showed that patients using antidepressants experienced, on average, faster cognitive decline than those who did not.

Some specific medications were particularly associated with greater decline:

• Escitalopram (an SSRI) was linked to the fastest cognitive deterioration.

• Citalopram and Sertraline, also SSRIs, showed significant associations with cognitive decline.

• Mirtazapine, an antidepressant with a different mechanism of action, was associated with less cognitive impact.

These findings suggest that the type of antidepressant matters significantly for cognitive outcomes in dementia patients.

Balancing Depression Treatment and Cognitive Health

Treating depression in dementia patients is critical, as untreated depression itself can worsen cognitive decline and quality of life. The study highlights a clinical dilemma: although some antidepressants may negatively affect cognition, untreated depression also carries serious risks.

The researchers stress the importance of careful, individualised treatment decisions, weighing benefits against potential risks, and considering non-pharmacological interventions such as psychotherapy, physical activity, and social engagement when appropriate.

Clinical Implications

This research could influence how healthcare providers manage depression in dementia patients. It may lead to:

• More cautious selection of antidepressant medications.

• Closer monitoring of cognitive changes in patients prescribed antidepressants.

• Development of more personalised treatment strategies combining medical and non-medical approaches.

Sensorem’s personal alarm has GPS positioning, medication reminders and automatic fall alarm

Sensorem’s personal alarm is an example of a technical aid specially developed for people with dementia. The personal alarm works outdoors and has built-in GPS positioning so that relatives can see the user’s position on a map in the Sensorem app. Relatives are automatically called by the personal alarm (two-way communication) if the user leaves a predetermined geographical area. The personal alarm also has medication reminders, which means that the watch emits a sound and tells the user that it is time to take their medication. The personal alarm can also alert automatically in the event of a fall with the built-in fall sensor.