A new study suggests certain antidepressants and anti-anxiety medications may not always be appropriate for people living with dementia
Dr Oscar Duke spoke out after a study found an increase in mortality among people taking some drugs while having dementia(Image: BBC)
A BBC health specialist has raised concerns following reports of heightened mortality dangers for particular people using antidepressants or anti-anxiety treatments. Research from Queen’s University Belfast has found, as stated by its lead author, that certain medications “may not always be appropriate” for those living with dementia.
Commonly prescribed medicines including Sertraline, Citalopram and Fluoxetine, used by millions throughout Britain, have been identified as a potential issue. On BBC Morning Live, Dr Oscar Duke offered his perspective, voicing specific concern about individuals using diazepam and lorazepam.
Discussing the connection between dementia and the mentioned medications last month, he stated: “This will be worrying because these are common anti-depressant medicines. So lots of people will be who will be watching will be taking these medicines or know somebody who do. Millions of people take them in the in the UK every day. So do not panic is the first thing to say. This is a specific study done in Northern Ireland looking at the impact of medicines on people with dementia.”
We could live to 200, men in danger of dying out, ‘Conan the Bacterium’ can’t be stopped, and woolly mammoths will be back in 2028 – all this and more in our latest science newsletter Dr Duke observed that individuals are typically living longer with dementia and, with no cure currently available, it poses an increasing challenge. It is calculated that almost 1 million (roughly 982,000) people are living with dementia in the UK as of May 2024.
He described how the research analysed medications given to dementia patients to assist in managing their symptoms, stating: “The reason this study was important is to try and find out the impact that things we do might have on people’s dementia. So commonly, we might give people who are struggling with their memory and all of the impacts of dementia something to help with their mood.
“You could understand that if you had dementia, it might make you feel more low, anxious, or depressed. And so this study tried to find out the impact of that, those medications that we might prescribe, an anti-depressant or an anti-anxiety tablet on your mortality and whether it affects your life expectancy.”
“And they did find some changes. Now, you know, no study’s perfect. So again, not to panic. There was a very small change with the anti-depressants. So, around an 8% increase in mortality over the 10 years that they looked at in that study.” Alongside the elevated mortality rate linked to these medications, researchers also uncovered considerably higher death rates amongst patients prescribed diazepam and lorazepam.
He added: “But for the anti-anxiety drugs, and these were drugs like things like diazepam and lorazepam, they’re often quite sedating drugs. So we might use for somebody who’s really anxious, distressed with something like dementia. There was a significant increase in mortality and people using those drugs up to about 26%.
“And we think it’s probably because as dementia is getting worse, you’re maybe more likely to need specifically those more sedating anxiety-type drugs. Of course, if you’re confused, if you’re then a bit more drowsy, you might be going to the loo in the middle of the night. You’re more likely to fall over. You’re then more likely to perhaps have an injury, break a bone, fracture a hip.
“And we know that all of those things have a poor impact on your life expectancy, particularly as you get older. And I suspect that in this study, the more severe your dementia is, the more likely you might be to be prescribed one of those sorts of medicines, particularly the more sedating type. And therefore, that might be why we see this larger increase in mortality as well. So I think not to panic if you’re somebody who’s taking one of these medicines, but worth having a conversation with your health care professional about whether it’s something that you really need and whether you’re really benefiting from it.”
Research from Queen’s University Belfast, conducted by academics from the School of Pharmacy and Centre for Public Health, has shown, according to its lead author, that particular medications “may not always be appropriate” for individuals living with dementia. Given that dementia is strongly associated with ageing and the proportion of those aged 65 and above continues to expand, dementia cases are projected to increase substantially. It presently impacts over 55 million individuals globally, with roughly 10 million new cases identified annually.
Widely prescribed drugs Sertraline, Citalopram and Fluoxetine, taken by millions across the country, have been flagged as a concern(Image: Getty)
Dr Catherine Sinnamon, lead author of the research and a postgraduate research student from the School of Pharmacy, emphasised that dementia was among the primary causes of death worldwide and “currently there is no effective treatment for the disease”. “It is therefore vitally important we look to ways to improve health and quality of life and reduce social and economic costs,” she said. People living with dementia commonly suffer from additional health complaints, meaning they are frequently prescribed several different medications.
“Sometimes these medicines may not always be appropriate. Our study aimed to uncover how antidepressant medications affect people with dementia to ensure we can provide them with the best treatment and care.”
The scientists analysed prescribing patterns of drugs used to treat depression and anxiety amongst dementia sufferers, investigating the relationship between the use of these medicines and mortality risk. The team studied 28,781 people living with dementia in Northern Ireland over a nine-year follow-up period (2012-2020), half of whom passed away during this time. The study found that antidepressants were prescribed to 59.2% of individuals who died during the follow-up period, while anti-anxiety medications were prescribed to 44.8% of these patients.
The results indicated a slightly increased risk of death amongst dementia patients prescribed antidepressants, and a considerably greater risk in those administered anti-anxiety medications. Dr Heather Barry, the study’s principal investigator, stated the findings “extend our knowledge and highlight the importance of judicious prescribing for people with dementia. It further underscores the importance of medications being regularly and thoroughly reviewed in people with dementia, whether that be by a GP or a pharmacist, to ensure they are still appropriate and are still needed,” she said.
The research received backing from personnel at the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO), with funding supplied by both the BSO and the Department of Health.