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Child Psychiatrist /Adult Psychiatrist

Antidepressants and Dementia Risk: New Data

TOPLINE:


Taking antidepressants in midlife was not associated with an increased risk of subsequent Alzheimer's disease (AD) or AD-related dementias (ADRD), data from a large prospective study of US veterans show.


Antidepressants

METHODOLOGY:


  • Investigators analyzed data from 35,200 US veterans aged ≥ 55 years diagnosed with major depressive disorder from January 1, 2000, to June 1, 2022, and followed them for ≤ 20 years to track subsequent AD/ADRD diagnoses.

  • Health information was pulled from electronic health records of the Veterans Health Administration (VHA) Corporate Data Warehouse, and veterans had to be at the VHA for ≥ 1 year before diagnosis.

  • Participants were considered to be exposed to an antidepressant when a prescription lasted ≥ 3 months.


TAKEAWAY:


  • A total of 32,500 individuals were diagnosed with MDD. The mean age was 65 years, and 91% were men. 17,000 patients received antidepressants for a median duration of 4 years. Median follow-up time was 3.2 years.

  • There was no significant association between antidepressant exposure and the risk for AD/ADRD (events = 1056; hazard ratio, 0.93; 95% CI, 0.80-1.08) vs no exposure.

  • In a subgroup analysis, investigators found no significant link between different classes of antidepressants and dementia risk. These included selective serotonin reuptake inhibitors, norepinephrine and dopamine reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors.

  • Investigators emphasized the need for further research, particularly in populations with a larger representation of female patients.


IN PRACTICE:


"A possibility for the conflicting results in retrospective studies is that the heightened risk identified in participants on antidepressants may be attributed to depression itself, rather than the result of a potential pharmacological action. So, this and other clinical confounding factors need to be taken into account," the investigators noted.


SOURCE:


The study was led by Jaime Ramos-Cejudo, PhD, VA Boston Healthcare System, Boston. It was published online May 8 in Alzheimer's & Dementia.


LIMITATIONS:


The cohort's relatively young age limited the number of dementia cases captured. Data from supplemental insurance, including Medicare, were not included, potentially limiting outcome capture.


DISCLOSURES:


The study was supported by the National Institutes of Health and the National Alzheimer's Coordinating Center. The authors declared no conflicts of interest.


Note: This article originally appeared on Medscape

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