Haims: Prescription antidepressants may have unwanted side effects

The rapid influx of new medications brought to market over the past decade has revolutionized health care by offering new treatments for many medical conditions. However, such innovations may have both positive and negative aspects. Perhaps we should give careful consideration before we buy into “there’s a pill for every condition.”

In the United States, prescription drugs have become more prevalent than ever before. This raises significant concerns regarding not only their widespread use and potential consequences when abused or when not taken as prescribed, but also the potential side effects.  

Annually, billions of prescription drugs are being filled in the U.S. According to the American Journal of Health-System Pharmacy, “In 2023, overall pharmaceutical expenditures in the US grew 13.6% compared to 2022, for a total of $722.5 billion.” And, “In 2021, overall pharmaceutical expenditures in the US grew 7.7% compared to 2020, for a total of $576.9 billion” — that’s an increase of $146 billion just a couple of years.

Last year, the Kaiser Family Foundation published some rather illuminating information about how many of us are taking prescription drugs. The data indicates that in 2021, about 60% of adults over the age of 18 are taking prescription medications. If this is not alarming, consider that between 1999–2000, data from the National Institutes of Health indicates that 51% of American adults had reported taking prescription drugs — that’s an increase of almost 10% of our population in a relatively short time span.

In just the past decade, remarkable progress has been achieved in addressing cognitive decline, particularly in the areas of research, treatment, and prevention. PET scans and blood tests are now able to detect amyloid plaques and tau tangles (protein deposits linked to Alzheimer’s) earlier in the disease process. Such progress is allowing earlier intervention before symptoms become severe.

Additionally, over just the past few years, there have been new medications developed that are believed to slow the progression of cognitive decline. For example, Aducanumab and Lecanemab (both targeting amyloid plaques) were approved by the FDA, thus potentially offering hope for slowing the progression of Alzheimer’s. While the efficacy and safety of these treatments are still being evaluated, we should all educate ourselves on the pros and cons of the medication we consume.

Recent research has found that there may be an association between cognitive decline and the use of some of the most commonly prescribed antidepressants and anxiety medications called selective serotonin reuptake inhibitors.

Over the past few months, researchers from the National Institutes of Health, the National Institute on Aging, Harvard Medical School, and the University of Oxford have been publishing reviews of a study from the Swedish Dementia Registry for Cognitive/Dementia Disorders that was conducted from May 1, 2007, until Oct. 16, 2018.

The Swedish Dementia Registry study was based on an analysis of data from 18,740 patients. The study indicates that not only are SSRIs possibly interacting negatively with several medications, but they may be exacerbating the potential risks for significant cognitive decline, fractures and all-cause mortality.

While evidence is still inconclusive, research indicates that long-term use of SSRIs, especially in older adults, may be linked to an increased risk of developing dementia. It is still debated whether SSRIs directly cause cognitive decline or if the underlying conditions treated by SSRIs (e.g., depression or anxiety) contribute to the increased risk.

We all need to be our own advocates. Should you be part of the cohort of people taking an SSRI, perhaps you should educate yourself with this new research. If nothing else, it would be a good idea to discuss this subject with your primary care provider.