Antidepressants fail to break link between depression and dementia

  • Chan JYC & al.
  • J Am Med Dir Assoc
  • 30 Jan 2019

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Patients with depression have a similarly elevated risk for dementia relative to the general population, whether they use antidepressants or not.

Why this matters

Key results

  • Among patients with depression, compared with antidepressant nonusers, users had elevated risks for:
    • Dementia (relative risk [RR], 1.37; 95% CI, 1.11-1.70).
    • Mild cognitive impairment (RR, 1.20; 95% CI, 1.02-1.42).
  • Compared with the general population, patients with depression had similarly elevated dementia risk whether they:
    • used antidepressants (RR, 1.48; 95% CI, 1.21-1.81) or
    • did not use antidepressants (RR, 1.31; 95% CI, 1.15-1.49).
  • RR for dementia vs general population by antidepressant class:
    • Selective serotonin reuptake inhibitors: 2.21 (95% CI, 1.44-3.40).
    • Serotonin norepinephrine reuptake inhibitors and atypical antidepressants: 4.74 (95% CI, 3.06-7.36).
    • Tricyclic antidepressants: 1.66 (95% CI, 1.20-2.31).
    • Monoamine oxidase inhibitors: 1.37 (95% CI, 1.22-1.50).

Study design

  • Systematic review, meta-analysis of longitudinal studies evaluating risks for dementia or mild cognitive impairment in patients with depression and/or antidepressant users.
  • Analyses based on 18 studies with 2,119,627 participants (mean age range, 54.6-81.1 years).
  • Main outcomes: dementia; mild cognitive impairment.
  • Funding: None disclosed.

Limitations

  • Heterogeneity of studies, populations.
  • Possible selection bias, confounding.