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. 2022 Jan;145(1):56-66.
doi: 10.1111/acps.13380. Epub 2021 Nov 2.

The risk of dementia in patients using psychotropic drugs: Antidepressants, mood stabilizers or antipsychotics

Marie Tournier  1   2 , Elodie Pambrun  1 , Sandy Maumus-Robert  1 , Antoine Pariente  1   3 , Hélène Verdoux  1   2
Affiliations

The risk of dementia in patients using psychotropic drugs: Antidepressants, mood stabilizers or antipsychotics

Marie Tournier et al. Acta Psychiatr Scand. 2022 Jan.

Abstract

Objective: The risk of dementia associated with the use of psychotropic drugs is not fully understood. A nested case-control study was carried out to assess the risk of dementia broadly defined or Alzheimer's disease associated with antidepressants, mood stabilizers or antipsychotics.

Methods: A cohort was formed from healthcare claim databases including all patients aged 50 and over with a first dispensing of the psychotropic drugs concerned between 2006 and 2017. Patients who developed dementia over the study period were considered as cases. The association between drug exposure prior to a five-year lag time and diagnosis of dementia was assessed by conditional logistic regression models.

Results: No association was found between dementia, either broadly defined or Alzheimer disease, and antidepressant or mood stabilizers. Findings were conflicting with regard to antipsychotics. First- and second-generation antipsychotics (FGA and SGA) were not associated with Alzheimer disease. SGA treatments of more than 3 months were associated with a higher risk of dementia broadly defined than no use of antipsychotics (Odds ratio [OR] 2.00; 95%CI 1.06-3.79; p = 0.03). In a sensitivity analysis using a lag time of 3 years, ever use of SGA and SGA treatments of more than 3 months were associated with a higher risk of dementia broadly defined than no use of antipsychotics (OR 1.71; 1.10-2.67; p = 0.02 and OR 1.84; 1.03-3.32; p = 0.04, respectively).

Conclusion: The association between antipsychotics and dementia should be further investigated to establish patients, specific drugs, and patterns of treatment at risk. Prescribers should remain cautious when prescribing them.

Keywords: Alzheimer disease; Dementia; antidepressant; antipsychotic; mood stabilizer.

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References

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