Sweden has ANOTHER psych med trial…but this one has some legit data in it.

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-025-03851-3

In another study done by Sweden……this time they looked at the development of dementia related to antidepressants. **important note: they are looking at increased loss of cognitive ability among patients who ALREADY have dementia**.

But this study actually puts drugs head to head instead of just labeling a drug class. The worst offender? Lexapro. Associated with increased worsening of dementia over a faster period of time compared to other SSRI’s. Next in line: Zoloft. Celexa also was noted to have some slight decline in cognition in already diagnosed dementia patients, but it actually slowed cognitive decline in patients with frontotemporal dementia. And rounding out the meds: Remeron. Which we use quite a bit of in people who have poor appetite and poor sleep. A common med in the elderly population.

One could argue that dementia progresses at varying rates, some quickly and some slowly. The stage of dementia when diagnosed also varies. Some get an early diagnosis, others it is delayed.

When you tie this into the study last week that was poorly done, and failed to name names of meds, this one is much better. While we do not know if use of antidepressants in younger years or prior to a diagnosis of dementia is clinically relevant in the development of dementia, I would expect a trial examining that to be forthcoming in the future.

“According to the scientists, three SSRIs (escitalopram, sertraline, citalopram) and one NaSSA (noradrenergic and specific serotonergic antidepressant) called mirtazapine were associated with faster cognitive decline, and the association was stronger in those suffering from severe dementia compared to those with dementia who are not using antidepressants.

The scientists point out that further research is required to understand if the cognitive decline was caused by the depressive symptoms or the antidepressants. What the study clearly demonstrates is that over time, antidepressants were associated with increased cognitive deterioration.”