Some antidepressants linked to dementia, study finds

Some antidepressants linked to dementia, study finds

Tricyclic antidepressants such as amitriptyline, which are also prescribed for pain and to help with sleeping, and one of the SSRI class, paroxetine (also known as Seroxat), are implicated by the largest ever study to look at this possible risk.

Though the 30% increased risk of developing dementia from long-term anticholinergic use is significant, it is still less than the risk associated with other modifiable risk factors for dementia such as smoking, social isolation and physical inactivity.

While study author Dr. Ian Maidment, a senior lecturer in clinical pharmacy at Aston University, urged medical providers to de-prescribe anticholinergic drugs, another of the study's authors recommended caution because more research is necessary to understand the link between the drugs and dementia.

The study found no risk with other anticholinergic medicines used to treat common conditions such as hay fever, travel sickness and stomach cramps.

The team examined the medical records by following 40,770 patients ageing between 65 and 99 along with the comparison between dementia detection from April 2006 to July 2015 and 283,933 people who didn't have dementia risk.

"It could be that these medications are being prescribed for very early symptoms indicating the onset of dementia".

This is the largest and most detailed study of its kind into the long-term impact of anticholinergic use in relation to dementia. Patients with dementia had a higher exposure to anticholinergics in the previous four to 20 years before diagnosis, the researchers from the University of East Anglia (UEA) found.

The study results suggested a "potential preventative approach" that demands further investigation.

The study concludes that clinicians should consider long-term anti-cholinergic effects when prescribing.

But this doesn't mean that these medications are directly causing dementia, and experts say patients should not stop taking any medicine without talking to their doctor.

The researchers, who report their findings in the British Medical Journal, investigated GP records for more than 40,000 people over the age of 65 with dementia and almost 300,000 without dementia.

"There are robust associations between levels of anticholinergic antidepressants, antiparkinsons, and urologicals and the risk of a diagnosis of dementia up to 20 years after exposure", they wrote.

"What we don't know for sure is whether the medication is the cause".

"But, because our research shows that the link goes back up to 15 or 20 years before someone is eventually diagnosed with dementia, it suggests that reverse causation, or confounding with early dementia symptoms, probably isn't the case".

"This research is really important because there are an estimated 350 million people affected globally by depression", comments lead researcher George Savva, Ph.D., a visiting researcher at the University of East Anglia's School of Health Sciences.

"Many of the treatment options for these conditions involve medication with anticholinergic effects". Despite this evidence, studies haven't been able to determine if the increased risk is specifically caused by the anticholinergic activity, or "whether or not the association is owing to the drugs or the underlying conditions for which they were prescribed", the authors note. "And we found that about 9% of our (dementia) cases had taken anticholinergics in the past, compared to about 6% of our controls".

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