New evidence shows some anti-depressants can raise dementia risk

The study dispels earlier fears around some hayfever drugs and dementia.

This is the largest study of its kind to examine the link between a family of drugs called ‘anticholinergics’ and dementia risk. These drugs block a key neurotransmitter in the brain called acetylcholine and are used to treat a variety of conditions including depression, bladder incontinence, Parkinson’s disease, hayfever and travel sickness.

Using the medical records of more than 300,000 people aged over 65 (40,770 with a diagnosis of dementia and 283,933 without), the researchers found that some anticholinergic drugs were linked to higher dementia risk (1). These included anticholinergic treatments for depression, bladder incontinence and Parkinson’s disease – but there was no evidence that medications for hayfever, travel sickness or stomach cramps raise the dementia risk, something which previous studies have suggested.

Dr Doug Brown, Chief Policy and Research Officer at Alzheimer’s Society who funded the new study, commented:

'Dementia is the UK’s biggest killer, and with no new treatments in 15 years, prevention is key. As well as our ongoing quest to find new treatments, we urgently need to understand what raises the risk of dementia so we can find ways to prevent it.'

'This large study confirms that some anticholinergic drugs can raise the risk of dementia – but it should put minds at ease as there appears to be no dementia risk with drugs used to treat common conditions like hayfever, travel sickness and stomach cramps.'

'Current guidelines for doctors say that anticholinergic drugs should be avoided for frail older people because of their impact on memory and thinking, but doctors should consider these new findings for all over-65s as long-term use could raise the risk of dementia.'

Alzheimer’s Society advice to the public in light of this research is:

• Doctors already know to carefully consider the short-term impact on memory when prescribing anticholinergic drugs to frail older people, but currently there isn’t clear guidance on prescribing them more generally.
• Certain anticholinergic drugs may raise the risk of developing dementia, so doctors should think carefully about writing long-term prescriptions for those particular anticholinergic drugs for people over 65.
• Frequently prescribed anticholinergic drugs include: anti-depressants Amitriptyline, Dosulepin and Paroxetine; bladder medications Tolterodine, Oxybutynin and Solifenacin; Parkinson’s treatment Procyclidine.
• Not all anti-depressants are anticholinergic and in most cases, alternative medications are available.
• If you’re concerned about how any medication you’re prescribed might affect your dementia risk, you should speak to your doctor and always be guided by them before you discontinue any treatments.
   

Find out more about risk factors with our dementia risk tool. 

For more information or to arrange an interview with an Alzheimer’s Society spokesperson, please call the press office on 0207 423 3595 or email [email protected].