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Antidepressant Treatment and Risk of Dementia: A Population-Based, Retrospective Case-Control Study
Abstract
OBJECTIVE: We investigated the relationship between antidepressant use and the risk of subsequent dementia development. METHOD: A population-based retrospective case-control analysis was conducted using the Taiwan National Health Insurance Research Database. From patients enrolled in the National Health Insurance program between 2005 and 2011, we identified 2 subsets: 5,394 cases, who had major depression in 1997-2004 and subsequently were diagnosed with dementia (ICD-9-CM code 290) in 2005-2011, and 5,232 controls, who had major depression in 2005-2011 but no dementia history. The proportional distributions of antidepressant use and comorbidities in the dementia case and nondementia control groups were compared. Univariable and multivariable logistic regression analyses were used to estimate the odds ratios (ORs) and 95% CIs for the association between dementia and antidepressant use. RESULTS: The dementia patients were more likely to have diabetes, hypertension, stroke, and head injury. The adjusted OR for dementia was 0.24 (95% CI, 0.22-0.27) in patients using tricyclics . By contrast, the use of selective serotonin reuptake inhibitors (SSRIs) (OR = 2.48; 95% CI, 2.27-2.71), monoamine oxidase inhibitors (MAOIs) (OR = 1.86; 95% CI, 1.47-2.36), heterocyclic antidepressants (OR = 1.44; 95% CI, 1.32-1.57), and other antidepressants (OR = 2.05; 95% CI, 1.85-2.27) was associated with an increased risk of dementia. Furthermore, as the cumulative dose was increased, tricyclic antidepressants reduced the risk of dementia, whereas SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants increased the risk of dementia. CONCLUSIONS: The incidence of dementia in patients is associated with antidepressant medication use. Treatment with tricyclic antidepressants was associated with a reduced risk of dementia, whereas treatment with SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants was associated with an increased risk of dementia.
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Lee et al. found that SSRI use was associated with an increased risk of incident dementia in older adults with depression, with an adjusted OR of 2.48 (95% CI 2.27-2.71).
“Another study by Lee et al., restricted to older adults with depression, found that SSRI use was associated with an increased risk of incident dementia, with an adjusted OR of 2.48 (95% CI: 2.27–2.71) [32].”
From Association between first-line antidepressant use and risk of dementia in older adults: a retrospective cohort study (2023) · cites this paper as [32]
In Lee et al.'s study, compared to non-dementia controls, dementia cases had longer follow up period from diagnosis of depression to endpoint of dementia.
“However, in their study, compared to non-dementia controls, dementia cases had longer follow up period from diagnosis of depression to endpoint of dementia.”
From Risk analysis of use of different classes of antidepressants on subsequent dementia: A nationwide cohort study in Taiwan (2017) · cites this paper as [53]
This study's result should provide more generalized results and could be more widely applied to populations regardless of depression status.
“Hence, our result should provide more generalized results and could be more widely applied to population regardless of the depression status [53].”
From Risk analysis of use of different classes of antidepressants on subsequent dementia: A nationwide cohort study in Taiwan (2017) · cites this paper as [53]
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Metadata
- Authors
- Lee, C. W.-S., Lin, C.-L., Sung, F.-C., Liang, J.-A., & Kao, C.-H.
- Affiliations
- China Medical University (TW)
- Corresponding author
- Kao, Chia-Hung
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2016-01-27
- Volume
- 77
- Issue
- 01
- Pages
- 117-122
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2260796177
- Cited by
- 61
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 7 · 2023: 9 · 2022: 3 · 2021: 3 · 2020: 11 · 2019: 10 · 2018: 5 · 2017: 10 · 2016: 1
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- antidepressants, dementia risk, major depressive disorder, tricyclic antidepressants, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, heterocyclic antidepressants, drug safety
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antidepressive Agents, Dementia, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Taiwan, Databases, Factual
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