Antidepressants and Dementia

The Use of Antidepressants for Dementia

The relationship between antidepressant use and the risk of dementia is complex and isn’t yet fully understood. Healthcare providers commonly prescribe antidepressants to manage the depression, anxiety, and agitation that can accompany dementia.

While they don’t cure psychiatric disorders or mood disorders, antidepressants help relieve symptoms by altering the balance of certain neurotransmitters in the brain (specifically serotonin, norepinephrine, and dopamine) that affect mood and emotions⁠^[1]. 

Antidepressants include SSRIs, SNRIs, and older classes such as tricyclics and MAOIs. Choosing a medicine requires an individual assessment of benefits, adverse effects, and other treatments^[10].

These should not be confused with dementia medicines. Memantine is an NMDA-receptor antagonist used for symptoms of moderate to severe Alzheimer’s disease; it is not an antidepressant treatment for depression^[9].

Since people can often remain on these medications for years or even decades, researchers recognized the need to explore the potential cumulative effects of antidepressants, including cognitive decline and dementia risk⁠^[2].

Studies Linking Antidepressants and Dementia

Dementia symptoms can worsen cognitive decline and impair quality of life, so proper treatment is important. Antidepressants have been linked to cognitive decline and dementia, but findings have been mixed so far.

The studies below examine different questions: developing dementia in the first place and cognitive change after a dementia diagnosis. Most are observational, so differences in depression, underlying illness, and prescribing can complicate interpretation. Associations do not establish that medication caused the outcome^[2][3].

Evidence is not uniformly negative. A 2024 population-based study found no consistent association between antidepressant use and long-term dementia risk, accelerated cognitive decline, or brain atrophy. That finding provides important context for studies reporting an association^[2].

Study on SSRIs and Dementia

Using data from 18,740 patients in the Swedish Dementia Registry, researchers found that people taking antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), experienced a faster rate of cognitive decline than those who did not take these medications⁠^[3]. 

Published in 2025, the study analyzed dementia patients who were newly prescribed antidepressants after their diagnosis⁠^[3]. They followed the participants over time to assess how their cognitive abilities changed, testing their cognitive function with a screening tool called the Mini-Mental State Examination (MMSE).

The associations differed by medicine and dose. These comparisons may also reflect differences in patients and why treatment was prescribed, so they should not be read as proof that a particular antidepressant caused deterioration^[3].

Study on Anticholinergic Drugs and Dementia

Many over-the-counter and prescription drugs have anticholinergic properties, meaning they block a neurotransmitter known as acetylcholine. These medications are commonly used by older adults, particularly those diagnosed with dementia⁠^[4]. This includes antidepressants with anticholinergic effects.

Researchers tracked nearly 3,500 adults aged 65 and older in the Adult Changes in Thought (ACT) study, using pharmacy records to identify the medications they had taken in the 10 years prior to enrollment⁠^[5]. 

During an average follow-up of about seven years, 797 participants developed dementia. The highest cumulative anticholinergic exposure category was associated with a 54% higher adjusted hazard of dementia compared with nonuse—not with three months of use. This estimate concerns strong anticholinergic medicines as a group and does not prove causation^[5].

The following antidepressants are associated with higher anticholinergic effects⁠^[5]:

• Amitriptyline: A tricyclic antidepressant (TCA) medication frequently cited for strong anticholinergic properties
• Paroxetine: A selective serotonin reuptake inhibitor (SSRI) with the highest anticholinergic activity in its class
• Doxepin: A sedating antidepressant with significant anticholinergic effects
• Imipramine: Another TCA medication that has anticholinergic activity and is linked to memory issues in long-term use

Subject matter expert

Natalie Staats Reiss Ph.D.

Older adults and caregivers

View experience

Study on Benzodiazepines and Dementia

Benzodiazepines are a separate class of medicines used for problems such as anxiety and insomnia; they are not antidepressants^[10]. A 2014 case-control study reported an association between longer benzodiazepine exposure and Alzheimer’s disease, but this design cannot establish cause and effect^[6].

Researchers relied on a database maintained by the Quebec health insurance program to identify nearly 2,000 men and women over the age of 66 who had already been diagnosed with Alzheimer’s disease⁠^[6]. Next, they randomly selected more than 7,000 others who had not been diagnosed with Alzheimer’s, but were matched in terms of age and sex to study participants with the condition⁠^[6]. 

The 2014 study reported higher odds of Alzheimer’s disease with longer exposure. Those odds ratios describe comparisons within an observational study, not an individual’s absolute chance of developing dementia^[6].

People who were prescribed a long-acting benzodiazepine like diazepam (Valium) or flurazepam (Dalmane) were at greater risk than those prescribed a short-acting one like triazolam (Halcion), lorazepam (Ativan), alprazolam (Xanax), or temazepam (Restoril)⁠^[6].

A later prospective study, published in 2016, found no increased dementia risk in its highest-exposure group and did not support a causal association. The differing results are a reason to discuss uncertainty and individual medication risks with a clinician^[8].

Recognizing Proven Dementia Risk Factors

It is still too early to say whether antidepressants may cause dementia. It is still under investigation if certain types of dementia or patients with specific genetic markers respond better or worse to antidepressants. 

Several medical, genetic, and lifestyle factors are known to play a role in the development of dementia, so it’s important not to isolate antidepressants as the sole focus of prevention efforts.

By having an understanding of the proven medical conditions that can cause dementia, patients and healthcare providers can work together to actively reduce or eliminate any modifiable risks while also effectively treating any psychiatric or mood disorders.

Some proven risk factors of dementia are⁠^[7]:

• Age
• Genetics
• Uncontrolled chronic conditions such as high blood pressure, diabetes, and obesity
• One’s amount of “cognitive reserve,” or the brain’s ability to cope with disease
• Exposure to air pollution
• Ethnicity
• Substance abuse or dependency, especially with existing concerns over whether alcohol can cause dementia

Using Antidepressants with Caution and Compassion

While some studies suggest a potential link between antidepressants and dementia, the evidence remains inconclusive and is often confounded by other factors.

These mixed results emphasize the need for more long-term, controlled studies to untangle the potential impact of antidepressants on the brain. Future research will undoubtedly provide more information about the potential impact of medication use and how it relates to dementia risk. 

Depression deserves assessment and treatment in its own right. These studies do not show that taking antidepressants prevents dementia. If memory or medication side effects concern you, ask your prescriber to review your treatment; do not stop a prescribed medicine without their guidance^[2][10].

If cognitive concerns arise, exploring options like psychotherapy, medication adjustments, or cognitive screenings can offer peace of mind and proactive health planning.