Study suggests link between psychiatric drugs and ALS risk

Taking common psychiatric drugs may be associated with an increased risk of diagnosis and progression of amyotrophic lateral sclerosis (ALS), according to a Swedish study.According to the case-control study published in JAMA Network Open, individuals who received at least two prescriptions for anxiolytics more than one year before their ALS diagnosis had a 34% increased risk (OR 1.34; 95% CI 1.12-1.60) of developing the disease. This risk increased by 26% for those who took antidepressants before their diagnosis (OR 1.26; 95% CI 1.06-1.49) and by 21% (OR 1.21; 95% CI 1.02-1.43) for those who received prescriptions for hypnotics or sleeping pills. Shorter survival was also observed in ALS patients who received anxiolytics (HR 1.52; 95% CI 1.12-2.05) or antidepressants (HR 1.72; 95% CI 1.30-2.29) prior to their diagnosis. The effect on prognosis was not significant for hypnotics and sedatives. The analysis was performed using a joint longitudinal-survival model that takes into account longitudinal changes in the ALSFRS-R since ALS diagnosis.The study is based on 1,057 patients diagnosed with ALS between January 2015 and July 2023, from the Swedish Motor Neuron Disease Quality Register. For each patient, five age- and sex-matched controls were randomly selected (for a total of 5,281 participants in the control population). Family members without ALS were also included in the study to reduce the effect of environmental factors on the results. The average age of participants was 67.5 years, and 53% were men. Five years before diagnosisPrescription data were extracted from the Swedish National Prescription Database, which records all treatments dispensed in pharmacies. Exposure was defined as the dispensing of at least two prescriptions for the same type of psychiatric medication. The researchers excluded prescriptions from the year prior to diagnosis, a period when psychiatric disorders may be part of the disease phenotype or result from distress associated with early symptoms. Analyses were performed using conditional logistic regression models adapted to matched data. “The increased risk of ALS associated with taking psychiatric drugs more than five years before diagnosis may indicate that psychiatric symptoms are prodromal symptoms of ALS, as is the case with other neurodegenerative disorders,” the researchers suggested. They point out that depression, anxiety, and sleep disorders can lead to structural changes in the brain attributed to HPA axis hyperactivity, glutamatergic dysfunction, metabolic changes, glial alterations and neuroinflammation. Links between psychiatric treatments and neurodegenerative disease have been rare and poorly documented until now. “These results suggest a potential link between psychiatric drugs, or their indications (psychiatric disorders), and the risk and progression of ALS,” wrote the research team. Further studies could help differentiate the effect of common psychiatric drugs on ALS risk from that of their underlying pathologies.This article has been translated from its original French and first appeared on our sister site Profession Santé.

Study suggests link between psychiatric drugs and ALS risk

Register for free access or login.

Related Topics

Business Topic