Study Finds Some Antidepressants Cause Cognitive Decline, Dementia and Fracture Risks

Lexapro was linked to the highest rates of cognitive decline, researchers determined.

While those with dementia are often prescribed antidepressants to help manage symptoms of anxiety and depression, new research indicates drugs like Lexapro and Celexa worsen dementia side effects and cause other harmful adverse effects.

Dementia patients taking antidepressants have a higher risk of death and breaking a bone, Swedish researchers warn in the study, which was published on February 25 in the journal BMC Medicine. The findings indicate that patients given high doses of some antidepressants face a 35% higher risk of developing severe dementia.

Antidepressants are a type of medication used to treat depression, anxiety, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

There are different classes of antidepressants that work differently on the brain, and while many Americans are prescribed antidepressants for depression and low mood, the drugs are often given to dementia patients to help pacify them and make them less unruly. This is a controversial practice known as “chemical restraint,” and is often considered a form of nursing home abuse.

Dementia is a group of conditions marked by symptoms that can interfere with daily life such as memory loss, difficulty with language and comprehension, impulsivity and withdrawal from social activities.

SSRIs Linked to Highest Rates of Cognitive Decline

Researchers from the Karolinska Institute in Sweden, led by Sara Garcia Ptacek, examined the link between antidepressants and cognitive decline risk due to their frequent use in dementia patients.

The study reviewed data from the Swedish Registry for Cognitive/Dementia Disorders-SveDem from May 2007 to October 2018, which included nearly 19,000 patients diagnosed with dementia.

Nearly one-quarter of dementia patients in the study received at least one prescription for an antidepressant, with a total of 12,000 prescriptions issued. The most commonly prescribed type was selective serotonin reuptake inhibitors (SSRIs), which accounted for 65% of cases. These include widely used medications like Celexa, Lexapro, Prozac and Zoloft.

The data revealed that patients taking antidepressants experienced a faster cognitive decline compared to those not taking the drugs. On average, dementia patients prescribed antidepressants saw their cognitive function decline by 0.30 points per year.

Among those taking SSRIs, the decline was even greater, averaging 0.39 points per year. In contrast, patients taking other types of antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) like Effexor or Cymbalta, and tricyclic antidepressants (TCAs) like Elavil, experienced a smaller cognitive decline of 0.20 points per year.

Lexapro, Celexa, Zoloft Risks

Certain antidepressants were linked to more severe declines in cognitive function. Patients taking Lexapro saw the most significant drop, averaging 0.76 points per year. Celexa users experienced a 0.41-point decline, Zoloft users saw a 0.25-point decline, and those taking Remeron experienced a 0.19-point decline annually.

In addition to cognitive decline, patients on antidepressants faced other health risks. The study found a 7% higher risk of death and an 18% increased risk of bone fractures among those taking the drugs. Higher doses of SSRIs were associated with even greater risks, including a 35% increased likelihood of dementia progressing to a severe state, a 25% higher risk of bone fractures, and an 18% greater risk of death. However, no increased fracture risk was observed among patients taking SNRIs like Effexor or Cymbalta.

With nearly 44 million American adults taking antidepressants each year—and usage rising, particularly among older adults—researchers stress the importance of careful monitoring for dementia patients prescribed these medications. Estimates suggest that 20% to 50% of dementia patients receive antidepressants, highlighting the need for physicians to regularly assess their condition.

To mitigate risks, researchers recommend that dementia patients on antidepressants undergo frequent follow-ups and testing. Regular cognitive assessments can help determine if their dementia is worsening, while bone density tests and other screenings can identify potential side effects before they become severe.