Work

Antidepressant exposure and long‐term dementia risk in a nationwide retrospective study on elderly patients with major depressive disorder

Year: 2025

Type: article

Abstract: BACKGROUND: The use of antidepressants in elderly patients with major depressive disorder (MDD) was associated with elevated risk of dementia, but the results published are conflicting. METHODS: Using the Taiwan Nationwide Health Insurance Research Database, 30,390 patients with MDD and 24,312 well-matched controls were enrolled between 2002 and 2004. MDD patients were stratified into 6,078 patients with antidepressant-resistant depression and 24,312 patients with antidepressant-responsive depression, and all participants were followed up until the end of 2013. Those who developed any dementia, Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia were identified. RESULTS: Patients with antidepressant-resistant depression and antidepressant-responsive depression were more likely to develop any dementia, AD, VaD, and unspecified dementia than controls. Patients with antidepressant-resistant depression group exhibited significantly higher risk of developing any dementia (hazard ratio [HR], 13.02 vs. HR, 7.70) and unspecified dementia (HR, 12.81 vs. HR, 7.33) than patients with antidepressant-responsive depression, which was also higher than controls. Subsequent analysis demonstrated that patients with antidepressant-resistant depression who were resistant to SSRIs only (HR, 12.01) or both SSRIs and non-SSRIs (HR, 13.87) consistently showed higher risks of developing any dementia than patients with antidepressant-responsive depression (HR, 7.70), which is also higher than controls. With antidepressant-responsive depression group as reference group, patients with antidepressant-resistant depression who were only resistant to SSRIs (HR, 1.56) and those with both resistant to SSRIs and non-SSRIs (HR, 1.80) have higher risk of developing any dementia, but there was no significant difference between the two groups. CONCLUSIONS: The use of antidepressants in elderly patients with MDD was associated with elevated risk of dementia.

Source: Alzheimer s & Dementia

DOI: 10.1002/alz70860_097934

Authors: Che‐Sheng Chu, Chih‐Sung Liang, Mu‐Hong Chen

Institutions: Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei Veterans General Hospital

Language: English

Topic: Treatment of Major Depression

Subfield: Pharmacology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,200