Higher Risk of Dementia from Depression Medication
New reports from a study carried out at the University of East Anglia have shown that common medication used by thousands, can lead to a higher risk of dementia. How significant this is, as well as the implications have left many begging the question. Should this be a cause for concern?
A study was led by the University of East Anglia, who studied the medical records of 40,770 patients over 65 years of age. All had been diagnosed with depression. Doctors compared this to the record of 283,933 other persons who have never been diagnosed with the condition.
The study showed a higher occurrence of dementia among the patients who had been prescribed anticholinergic depressants.
Anti-Depressants and the Link with Dementia
Anticholinergic drugs work by blocking acetylcholine, a major neurotransmitter in the body. They are commonly prescribed by physicians to address conditions ranging from depression, Parkinson’s disease, and incontinence.
Common medications such as amitriptyline, paroxetine, and dosulepin used to treat depression had the greatest link to dementia. Also revealed from the study is the possible link between incontinence medications such as tolterodine, and solifenacin.
Parkinson’s Drugs and the Link with Dementia
Although not as pronounced as the other two cases above. Medications used in treating Parkinson’s disease such as procyclidine was also linked to dementia. No valid link was seen between other anticholinergics including the antihistamines and the other drugs used for stomach cramps. Although a previous study had suggested they may cause long-term cognitive decline.
As much as two million people in England and more people in the US are likely to have been prescribed these drugs. The study established a link between depression and the anticholinergics. Patients with dementia had higher exposure to these drugs in the previous four to twenty years preceding the diagnosis. Considering that an estimated 350 million people are dealing with depression globally, this should really be a source of worry.
Patients between the ages of 65 to 70 years are 10% more likely to develop dementia in the course of the next 15 years. This risk is then further increased by as much as three percentage points among patients who had been exposed to anticholinergic drugs for more than a year.
How Anti-Depressants Increase the risk of Dementia
Dr. George Savva, the Lead researcher from the UEA’s school of health sciences said:
“what we don’t know for sure is whether the medication is the cause. It could be that these medications are being prescribed for very early symptoms indicating the onset of dementia. 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.”
Anti-Depressants and the Link with Dementia: The Way Forward
According to Dr. Doug Brown who happened to be the lead pharmacist on the study, people need to be more conservative with the use of these drugs. Adding more weight to this is Dr. Chris Fox, a professor of clinical psychiatry at UEA, “further research is needed to understand possible reasons for this link.”
In the meantime, I strongly advise patients with any concerns to continue taking their medicines until they have consulted their doctor or pharmacist.”
As pointed out above that the mechanism involved in the causation of dementia by these anticholinergic drugs is yet to be ascertained, still, de-prescribing should be one important option we may need to consider as a lot of medications have anticholinergic properties. According to Dr. Ian Maidment, a co-author on the study. Clinical staff, carers, as well as the patients need to collaborate together. This way the potential harms associated with anticholinergics can be significantly limited.