A Queen’s University Belfast study has found increased mortality risks for some patients
Dr Oscar Duke has shared information about a new study
A well-known BBC NHS GP has addressed emerging research suggesting heightened mortality risks for certain individuals prescribed antidepressants or anti-anxiety treatments. The recent Queen’s University Belfast investigation indicates, according to its principal researcher, that particular medications “may not always be appropriate” for dementia patients.
Medicines including Sertraline, Citalopram and Fluoxetine, currently prescribed to millions nationwide, have come under scrutiny, with BBC Morning Live’s Dr Oscar Duke offering his expert analysis on the show on Wednesday. He emphasised the study raised particular concerns regarding diazepam and lorazepam users.
Discussing the dementia-related findings and the highlighted pharmaceuticals, he stated: “This will be worrying because these are common anti-depressant medicines. So lots of people will be who will be watching will be taking these medicines or know somebody who do. Millions of people take them in the in the UK every day. So do not panic is the first thing to say. This is a specific study done in Northern Ireland looking at the impact of medicines on people with dementia.”
Dr Duke noted that individuals are increasingly living longer with dementia diagnoses, and without available treatments to reverse the condition, it represents an escalating public health challenge. Current figures suggest almost one million (roughly 982,000) individuals are living with dementia across the UK as of May 2024.
Dr Oscar Duke spoke out after a new study found an increase in mortality among people taking some drugs while having dementia(Image: BBC)
He outlined how the research examined medications administered to dementia patients for symptom management, stating: “The reason this study was important is to try and find out the impact that things we do might have on people’s dementia. So commonly, we might give people who are struggling with their memory and all of the impacts of dementia something to help with their mood.”
“You could understand that if you had dementia, it might make you feel more low, anxious, or depressed. And so this study tried to find out the impact of that, those medications that we might prescribe, an anti-depressant or an anti-anxiety tablet on your mortality and whether it affects your life expectancy.
“And they did find some changes. Now, you know, no study’s perfect. So again, not to panic. There was a very small change with the anti-depressants. So, around an 8% increase in mortality over the 10 years that they looked at in that study.”
Findings on diazepam and lorazepam
Beyond the elevated mortality risk associated with antidepressants, the research uncovered substantially higher death rates amongst patients prescribed diazepam and lorazepam, reports the Mirror. He elaborated: “But for the anti-anxiety drugs, and these were drugs like things like diazepam and lorazepam, they’re often quite sedating drugs. So we might use for somebody who’s really anxious, distressed with something like dementia. There was a significant increase in mortality and people using those drugs up to about 26%.
“And we think it’s probably because as dementia is getting worse, you’re maybe more likely to need specifically those more sedating anxiety-type drugs. Of course, if you’re confused, if you’re then a bit more drowsy, you might be going to the loo in the middle of the night. You’re more likely to fall over. You’re then more likely to perhaps have an injury, break a bone, fracture a hip.
“And we know that all of those things have a poor impact on your life expectancy, particularly as you get older. And I suspect that in this study, the more severe your dementia is, the more likely you might be to be prescribed one of those sorts of medicines, particularly the more sedating type. And therefore, that might be why we see this larger increase in mortality as well. So I think not to panic if you’re somebody who’s taking one of these medicines, but worth having a conversation with your health care professional about whether it’s something that you really need and whether you’re really benefiting from it.”
Research conducted by Queen’s University Belfast, spearheaded by experts from the School of Pharmacy and Centre for Public Health, has revealed that certain medications “may not always be appropriate” for individuals living with dementia, according to the lead author. With dementia linked to advancing age and the number of people aged 65 and above rising, cases of the condition are expected to climb.
More than 55 million individuals across the globe are affected, with roughly 10 million new diagnoses occurring annually. Dr Catherine Sinnamon, principal author of the study and postgraduate researcher at the School of Pharmacy, emphasised that dementia ranks among the foremost causes of death worldwide and “currently there is no effective treatment for the disease”.
“It is therefore vitally important we look to ways to improve health and quality of life and reduce social and economic costs,” she explained. Those living with dementia frequently manage additional health conditions, resulting in multiple medication prescriptions.
“Sometimes these medicines may not always be appropriate. Our study aimed to uncover how antidepressant medications affect people with dementia to ensure we can provide them with the best treatment and care.”
Medicines treating depression and anxiety – patterns
The investigation examined prescribing patterns for medicines treating depression and anxiety amongst dementia patients, while exploring links between these medications and mortality risk. The research team analysed data from 28,781 individuals with dementia across Northern Ireland throughout a nine-year monitoring period (2012-2020), with half passing away during this timeframe.
The research revealed that 59.2% of individuals who passed away during the monitoring period had been prescribed antidepressants, whilst 44.8% had received anti-anxiety medications. Evidence suggested a modest elevation in mortality risk amongst dementia patients prescribed antidepressants, and a substantially heightened risk in those given anti-anxiety drugs.
Dr Heather Barry, principal investigator on the study, said the findings “extend our knowledge and highlight the importance of judicious prescribing for people with dementia. It further underscores the importance of medications being regularly and thoroughly reviewed in people with dementia, whether that be by a GP or a pharmacist, to ensure they are still appropriate and are still needed,” she said.
The research received support from personnel at the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO). Funding for the HBS comes from both the BSO and the Department of Health.