Associations seen for sertraline, citalopram, escitalopram, and mirtazapine
By Elana Gotkine HealthDay Reporter
WEDNESDAY, March 5, 2025 (HealthDay News) — Current antidepressant use is associated with faster cognitive decline in patients with dementia, according to a study published online Feb. 25 in BMC Medicine.
Minjia Mo, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined the association between antidepressants and cognitive decline in patients with dementia in a national cohort study. Data were included for 18,740 patients, of whom 22.8 percent received at least one prescription for an antidepressant.
The researchers found that 11,912 prescriptions for antidepressants were issued during follow-up, with selective serotonin reuptake inhibitors (SSRI) being the most common (64.8 percent). Compared with nonuse, there was an association for antidepressant use with faster cognitive decline (β = −0.30 points/year), especially for sertraline, citalopram, escitalopram, and mirtazapine (β = −0.25, −0.41, −0.76, and −0.19 points/year, respectively). Patients with severe dementia (initial Mini-Mental State Examination scores 0 to 9) had a stronger association. A greater rate of decline was seen for escitalopram than sertraline. Dose response of SSRIs on greater cognitive decline and higher risks for severe dementia, all-cause mortality, and fracture were seen compared with nonuse.
“Our study cannot distinguish whether these findings are due to the antidepressants or the underlying psychiatric indication,” the authors write.
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