Do antidepressants cause dementia?

Mar 29, 2023 | Medicine, Mental health

Doctors prescribe antidepressants for their effectiveness in treating anxiety and depression, with patients taking the medication for at least several weeks before they switch medication or dosage amounts under the supervision of their doctor.

Thousands of studies have been conducted worldwide about the side effects, risk factors and any long-term effects of taking antidepressant medicines, whether they be selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs) or other atypical forms of antidepressant medicines.

It is always good to research any side effects or potential long-term risks when starting any ongoing prescription medication for any health concern.

Recent studies have found some antidepressants may increase the risk of memory problems and confusion in a small percentage of elderly individuals. However, this area of medicine is still under research and care must be taken in trying to fully understand the association between the two and indeed whether this is actually dementia as opposed to a memory side effect of medication.

Complicating the picture is that elderly individuals as a consequence of physical problems (eg cardiovascular disease) are at increased risk of dementia. Moreover, when one is severely depressed an individual has increased risk of memory and cognitive deficits which are temporary and secondary to depression.

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What is dementia?

Dementia is a neurocognitive, incurable, progressive disorder leading to patients becoming cognitively and physically impaired. The two most common types of dementia are Alzheimer’s disease and vascular dementia.

In 2023 it is estimated there are over 400,000 people living with all forms of dementia in Australia. This figure is projected to increase to over 800,000 by 2058.

Although it is more commonly seen in the elderly, 40 and 50-year-olds, have been known to develop early onset dementia. Symptoms of dementia may occur over months or years, although it is advised always to consult your doctor to support you through any diagnosis.

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Signs of dementia include;

  • Loss of memory
  • Speech and language difficulty
  • Changes in personality
  • Mood changes, for example, becoming more irritable.
  • Difficulty performing familiar everyday tasks such as getting dressed
  • Loss of sense of time and place, sleeping irregular hours.

The link between antidepressants and dementia explained:

Do antidepressants cause memory loss or indeed dementia? One possible explanation for the link between antidepressants and memory loss is the use of anticholinergic medications such as tricyclic antidepressants like amitriptyline. With most elderly patients prescribed at least five different medicines tablets a day, there is a reasonable prospect that one of their medications has an anticholinergic effect.

Anticholinergics are a class of medication that blocks the action of acetylcholine. Acetylcholine is the chemical in our brains controlling the messages transmitted from one cell to another. Anticholinergics block the binding of acetylcholine to its receptor in nerve cells affecting the body’s nervous system and ability to react.

Tricyclic antidepressants such as amitriptyline, are a common form of medicine with anticholinergic side effects, prescribed for mental health, pain and sleep issues. It is with elderly patients that it can be seen that these types of antidepressants can increase the risk of memory loss and potential risk of falls as they tend to have a sedation effect calming both the mind and body for some time.

Moreover, some antidepressants have been found to increase confusion in someone with existing dementia, making it harder for them to live their daily life and more difficult for their carers to manage.

However, some studies have also found that Selective Serotonin Reuptake Inhibitors (SSRIs) prescribed to patients with Alzheimer’s have experienced improved cognitive function.

Doctors should exercise caution when prescribing antidepressants to an elderly person and discontinue use if they present any symptoms of memory loss.

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Monitoring your symptoms

It is highly recommended when you start taking any new ongoing prescription medication, especially ones such as antidepressants, to closely monitor your symptoms and any side effects you might be suffering from.

Having a close friend or family member that is also in check of your mood, and educated on the types of symptoms that might be indicative of complications associated with antidepressants and also advised, such as taking note of memory loss, or any difficulty with speech and sudden changes in personality.

If in doubt, it is always best to contact your doctor or another medical professional to assess the issue and check if it is something to be concerned about.

To learn more, we recommend you search myDr for available medicines.

References:

https://www.news-medical.net/health/Antidepressants-and-Dementia-Is-there-a-Link.aspx

https://www.healthdirect.gov.au/dementia-overview

https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain

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Medically reviewed by Dr Matt Cullen
MBBS, FRANZCP

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