Antidepressants Linked to Faster Cognitive Decline in Dementia Patients

Antidepressants are touted as a solution to help improve people’s mental health and ease depression and anxiety. But these “convenient” little pills are more harmful than you think, as they alter your brain chemistry, making your condition worse than ever.

Recent research sheds light on the dark side of these commonly prescribed medications, showing that individuals with dementia who took antidepressants had faster cognitive decline.

The assumption has been that managing mood disorders in dementia patients would improve their overall condition. But instead of offering relief, it turns out that antidepressants accelerate the very decline they were meant to ease.

Antidepressants Accelerate Dementia Faster Than Expected

A recent observational study published in BMC Medicine¹ examined how antidepressants impact cognitive decline in dementia patients. The researchers used data from the Swedish Dementia Registry, focusing on dementia patients prescribed selective serotonin reuptake inhibitors (SSRIs). The data included 18,740 patients, 23% of whom were given antidepressants. Sixty-five percent of these prescriptions were SSRIs, including citalopram and escitalopram.²

• The speed of cognitive decline increased — The findings were alarming — according to the researchers, dementia patients who took antidepressants lost cognitive function at nearly twice the expected rate compared to those not on these medications. The patients on these drugs had an accelerated decline in memory, reasoning and overall cognitive ability.
• The decline was most pronounced in patients with moderate to severe dementia — Instead of a gradual decline over several years, the cognitive abilities of patients with more advanced dementia diminished rapidly when taking SSRIs.
• Higher doses led to worse outcomes — The study found a dose-dependent relationship, meaning that the higher the antidepressant dose, the faster the cognitive decline. What’s more, patients on higher doses had increased risks of hospitalization, fractures and even death.
• The risk was especially high for certain groups — Elderly patients with frailty or chronic conditions face higher risks of hospitalization and mortality when prescribed antidepressants, raising concerns about the routine use of these drugs in nursing homes.³

The biological explanation behind these findings points to how SSRIs affect brain function. These drugs work by increasing serotonin levels, however, they also interfere with other crucial neurotransmitters and brain processes. In dementia patients, whose brains are already struggling with neurodegeneration, this interference accelerates damage rather than slow it down.

Previous Studies Already Link Antidepressants to Increased Dementia Risk

An earlier meta-analysis published in the journal Behavioural Neurology⁴ also examined whether antidepressant use increases the likelihood of developing dementia. The researchers reviewed data from 53,955 participants across multiple observational studies, making it one of the most comprehensive investigations into the long-term effects of antidepressant use.

The findings were clear — individuals who took antidepressants had a significantly higher risk of developing dementia compared to those who never used these medications.

• People who took SSRIs had a 75% greater chance of developing dementia — The researchers found that if you’re taking an SSRI long-term, your likelihood of experiencing cognitive decline is significantly higher than someone who is not on these medications.
• It’s not just SSRIs — Other categories of antidepressants also carry serious risks. The researchers note that tricyclic antidepressants (TCAs) more than doubled the risk of dementia, making them even worse in terms of progression. Another category of antidepressants, monoamine oxidase inhibitors (MAOIs), showed an even steeper increase, with users experiencing nearly three times the risk of dementia compared to non-users.

Although MAOIs are not as frequently prescribed today, their impact on brain function is profound, suggesting that all types of antidepressants carry real dangers when it comes to cognitive health.

• Longer use of antidepressants made the risk worse — The study found that people who had been taking antidepressants for over a year had dramatically higher dementia rates compared to those who had taken them for only a few months. The longer a person was exposed to these medications, the more their risk increased.
• Men are at even greater risk than women — The research suggested that males taking these medications had a higher likelihood of developing dementia earlier and at a more rapid pace than females. This raises serious concerns about how antidepressants interact with male brain chemistry, hormones, and metabolism.⁵

How Do Antidepressants Put You at Risk of Dementia?

The researchers also provided insights into how antidepressants alter your brain’s chemistry. SSRIs, for example, artificially increase serotonin levels while reducing other crucial neurotransmitters involved in memory and learning.⁶

• Antidepressants trigger imbalance in your brain’s pathways — When your brain’s pathways are imbalanced for many years, it affects normal brain function and leads to long-term damage. According to the researchers, “[U]se of antidepressants might prompt the imbalance of various neurobiological pathways. Therefore, it could help to elevate oxidative and nitrosamine stress as well as inflammation.”⁷
• Antidepressants increase brain inflammation — Inflammation plays a significant role in neurodegenerative diseases, including Alzheimer’s and other forms of dementia.⁸ Long-term inflammation damages brain cells, disrupts neural connections and contributes to the buildup of harmful proteins that accelerate cognitive decline.
• Antidepressants interfere with brain metabolism and detoxification — Your brain relies on a delicate balance of metabolic processes to remove harmful waste products, such as beta-amyloid proteins, which are heavily implicated in Alzheimer’s disease. When antidepressants interfere with these processes, toxins accumulate more rapidly, leading to faster cognitive decline.

The way antidepressants work is based on the serotonin hypothesis, which posits that low serotonin levels in your brain are responsible for symptoms of depression. However, the problem is that a number of studies have already debunked this hypothesis, including a 2022 umbrella review in Molecular Psychiatry.⁹

In fact, the study notes that low serotonin is associated with long-term antidepressant use, which is basically the converse effect you’d expect if the serotonin theory was true.

What Are the Consequences of Long-Term Use of Antidepressants?

Some might assume that depression itself is responsible for the increased dementia risk, rather than the antidepressants. However, as noted in the Behavioural Neurology paper, the researchers accounted for this by comparing antidepressant users to people who had depression but did not take medication. They found that those who are depressed but did not take these medications still had a significantly lower risk of dementia than those who used these drugs.¹⁰

An earlier study also reported similar findings. Published in the journal Alzheimer’s Disease and Associated Disorders,¹¹ the researchers investigated whether long-term antidepressant use in older adults without dementia increased their risk of developing the disease.

• The 18-year study tracked elderly individuals with no dementia — Researchers analyzed data from 3,688 individuals aged 60 and older, all of whom had no dementia at the beginning of the study. They were monitored over an 18-year period, with medical records tracking both their antidepressant use and any subsequent dementia diagnosis.
• SSRI use significantly increased dementia risk — As in the studies above, those who took antidepressants, especially SSRIs, had a significantly increased risk of developing dementia compared to non-users.
• The drugs themselves appear to be driving cognitive decline — If depression alone were responsible, then both groups (those who took medication and those who didn’t) should have had similar dementia rates. The stark difference in outcomes points to antidepressants being a major contributing factor in neurodegeneration.
• Higher doses over extended periods also worsened the problem — This reinforces the idea that these medications are not just a short-term risk but an ongoing threat to brain health. If you or a loved one has been on antidepressants for several years, you’d be wise to reassess whether they are truly necessary.¹²

GABA Is a Better Choice for Your Mental Health

Depression is routinely treated with SSRIs under the belief that it’s caused by a deficiency in serotonin, often mistakenly referred to as the “happiness hormone.” However, low serotonin level is not responsible for depression; rather, it’s excessive serotonin levels that may be the issue.

• Having excessive serotonin levels destroys empathy, love and wisdom — It also impairs thyroid function, reduces your metabolism and contributes to premature aging by increasing reductive stress.
• Address GABA deficiency instead — A far more common problem in depression is gamma-aminobutyric acid (GABA) deficiency. This is why increasing your GABA levels is a more effective solution for conditions typically treated with SSRIs, without the adverse effects associated with elevated serotonin.
• My recommended GABA dose — I recommend a daily GABA dose of 500 milligrams to 2,000 milligrams (2 grams). This range has been shown to help relieve anxiety and insomnia in individuals already taking SSRI drugs.
• GABA supports optimal mitochondrial function — Interestingly, if you take too much GABA, some of it will be deaminated and converted into succinic acid, an intermediate of the Krebs cycle. This means that at high doses, GABA also helps boost mitochondrial function, making it a very safe option from a toxicity perspective.

To learn more about the advantages of GABA over antidepressants, read “Study Reveals Varying Weight Gain Risks With Different Antidepressants.”

Five Steps to Protect Your Brain and Reduce Dementia Risk

The good news is that there are simple ways to protect your brain, uplift your mental health and reduce your risk of cognitive decline. The key is addressing the root causes of both depression and neurodegeneration. That means improving brain metabolism, supporting neurotransmitter balance naturally and avoiding medications that accelerate the problem. Here are five steps you can take right now:

Making these changes will help protect your brain, improve your mood naturally and reduce your risk of developing dementia. You don’t have to rely on medications that only make things worse — your brain has the ability to heal when given the right environment.

Frequently Asked Questions (FAQs) About Antidepressants and Dementia