Psychiatric Drugs Increase Dementia Risk Threefold After COVID in 65+ Population

Hospitalized COVID patients over 65 were three times as likely to receive a dementia diagnosis if they took psychiatric drugs.

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In a new study of patients at least 65 years old hospitalized with COVID-19, researchers found that those who took psychiatric drugs were more than three times as likely to receive a dementia diagnosis within one year. According to the researchers, the results were unique to psychiatric drug use, not driven by underlying mental health conditions.

“Prior use of antipsychotics, antidepressants, benzodiazepines and mood stabilizers/anticonvulsants, were significantly associated with a higher risk of incident post-COVID dementia.”

The study was published in Frontiers in Medicine. It included 1,755 patients at least 65 years old hospitalized with COVID-19. Dementia occurred in 12.7% of the participants over the next year. Those who had previously taken psychiatric drugs were 3.2 times more likely to receive a dementia diagnosis.

But this result could have been driven by the underlying psychiatric diagnosis and not the drugs. So the researchers did a second analysis of only the 423 participants who had a psychiatric diagnosis to account for this. If dementia were linked to underlying mental health and not psychiatric drugs, we would expect to see no (or very little) difference between those who took psychiatric drugs versus those who did not in this smaller group.

Instead, the researchers found that psychiatric drugs still raised dementia risk threefold. Among only those with a psychiatric diagnosis, those who took psychiatric drugs were still 3.09 times more likely to receive a diagnosis of dementia than their peers.

Some of the commonly used drugs that were associated with extremely high risk included valproic acid/valproate (11.57 times more likely to receive a dementia diagnosis); haloperidol/Haldol (8.44 times more likely); mirtazapine/Remeron (6.02 times more likely); levetiracetam/Keppra (5.91 times more likely); clonazepam/Klonopin (3.97 times more likely); quetiapine/Seroquel (3.9 times more likely); and escitalopram/Lexapro (3.49 times more likely).

The researchers then did two tests called Random Forest (which uses machine learning) and LASSO regression, both of which are designed to check again whether this result was true. Again, both of these tests confirmed the effect.

This is not the first time these drugs have been found to increase dementia. Antipsychotics have been found to increase the risk of dementia, as have antidepressants and benzodiazepines. Researchers in 2016 found that valproic acid/valproate increased dementia risk in people with a bipolar diagnosis. A 2018 study found that those who used antiepileptic drugs—like levetiracetam/Keppra—also had a higher risk of dementia.

Oddly, despite their multiple tests using documented psychiatric diagnoses to confirm that the effect was due to the drugs, the researchers still suggest that the drugs may be “risk markers that signify neuropsychiatric symptoms” but admit that they likely also “contribute to post-COVID dementia.”

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The authors’ financial conflicts of interest with the pharmaceutical industry are listed below:

Consulting fees, payments, honoraria, or support for attending meetings: MC: Board fee from Haven Behavioral Health Care Board; SUNY Downstate School of Medicine Department of Medicine Grand Rounds; Maimonides Medical Center Department of Medicine Grand Rounds; Board of Governors of American College of Physicians 2018–2021 meetings; JK: Consultant to or receives honoraria: Alkermes, Allergan, Dainippon Sumitomo, H. Lundbeck, Indivior, Intracellular Therapies, Janssen Pharmaceutical, Johnson & Johnson, LB Pharmaceuticals, Merck, Minerva, Neurocrine, Novartis Pharmaceuticals, Otsuka, Reviva, Roche, Saladex, Sunovion, Takeda, Teva Grant Support: Otsuka, Lundbeck, Sunovion, Vanguard Research Group LB Pharmaceuticals, and North Shore Therapeutics; Participation on Data Safety Monitoring Board or Advisory Board: JK: Teva and Novartis; EB: PCORI Eugene Washington Award advisory panel member. Leadership or fiduciary role: MD: Society of Behavioral Medicine, President and past President (unpaid). EB: Society of Behavioral Medicine: nominating committee; annual program committee (unpaid). Associate editor, Translational Behavioral Medicine (unpaid). Stock or stock options: YF-H co-owns stock and stock options from Regeneron Pharmaceuticals.

The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

 

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Freudenberg-Hua, Y., Makhnevich, A., Li, W., Liu, Y., Qiu, M., Marziliano, A., . . . & Sinvani, L. (2022). Psychotropic medication use is associated with greater 1-year incidence of dementia after COVID-19 hospitalization. Frontiers in Medicine. https://doi.org/10.3389/fmed.2022.841326 (Link)

14 COMMENTS

  1. Why call brain damage dementia?

    Possibly it softens the notion of pharmacological negligence to speak of a population getting an unwanted effect they were by all accounts apparently destined for anyway, a shoulder shug that says its sort of normal “to age”. A shoulder shrug of flipancy that shuffles the unsightly impact of that damage into the realm of “characterful grandma” or “dear old grandfather”. Really a damaged brain is a damaged whole person.

    Covid is not a cough. Covid is a vascular disease. It gums up blood vessels in the brain. A brain that is already shrivelled from medication may not have as many generous circulatory avenues to funnel that virus around in.

    There needs to be a new name for such covid brain damage, to those compromised by iatrogenesis, a name that does not sound like the avuncular cuddly knitting and crossword puzzle word “dementia”.

  2. Further to my early comment I must add that whilst I have strong reluctance against the over prescribing of medications I do not blame anyone for choosing the option of medication for themselves if they feel they need it. I have friends who would be dead in a week if they could not access their drug of choice. I do not think it is for anyone to be bossing anyone around to give up whatever they need to get by. And I think many doctors are often villified if they give nothing but hope in a natural recovery. Desperate people demand instant alleviaton of suffering. What annoys me is the lack of transparency about the ill effects from being on such medications long term. Subterfuge not science.

  3. Nice points.

    I like to think that there is no division between mental ill health and physical ill health. Brain and body are connected.
    This position can be used by others to say that any mental illness is nonsense and is just a depletion or toxicity or disease in the body.
    But by that same token any physical illness can be said to be affected by the brain. The mental compartment. Then in a subtler aside there is the way the mental attitude can impact healing.

    In regard of emotions at what point do we say the emotions are from our psyche and not just our physical body, as in adrenalin fear states and melatonin sleepiness and so on. Where do we draw that line.

    I intuitively feel that my brain suffers ill health just as much as my body suffers ill health. I feel it is absurd to think these are not interwoven on an atomic or energetic level to the extent of my being one whole complete person. If my body can get sick, so can my mind or brain get sick. Someone in shock is not well, however you care to word…

    “wellness/not wellness”.

    When I feel my mind or brain is where my unwellness is manifesting more, I need caring support with that. Particularly in the case of iatrogenic brain damage. Something many agree can mimic psychosis.

    I understand that many just want to have an idea that the brain is pristine and normal always and nothing of shock, or unwellness or damage or illness ever happens to it. I do not think that this is possible, given how linked the brain and body are, and given how often the body gets sick. Hormones are so poweful that when one hormone is needed to start any aspect of change such as is seen in puberty the quantity required by the “brain-body” is the equivallent of one tear drop of ink falling into an Olympic swimming pool. Very miniscule events of hormones or brain neurochemicals is all it takes to make massive changes to mood and meat. To say those things do not happen seems dismissive. I think people want there not to be any such thing as mental ill health, given that the body has ill health, because they do not want it…

    “badly treated”.

    But that then means those who have iatrogenic damage that affects their brain and cognition, memory and mood, presumably are supposed to forget their ongoing abject suffering.

    I have white leisons in my brain. I suspect they come from my quaffing back antipsychotics for years. I feel those leisons affect me in ways that are different to how my schizophrenia affects me. My schizophrenia occurred a decade before any medication and I have a prior scan for that timeframe. These recent leisons are causing me all sorts of emotional mischief. Psychiatric effects. We can call that “p” word by another name in an era of renaming everything, but whatever we call that specific “mental” aspect of the one interwoven “brain-body”, its “sickness” really does beg a response of care or even compensation. If there is a sickness in the “brain-body”, one that specifically impacts the mental aspect, call it by another name if you will, then that sickness needs to be recognized enough to take it seriously enough to offer the “choice” of care to it. For a sickness to be regarded at all as a reality it will need a diagnosis. In future maybe the person with the sickness will get to make up their own diagnosis, to swerve getting stigmatized with a term not of their “choice”, but they cannot call it “a sore knee” without going home in a knee bandage.

    All I am saying is my mind is real to me. Call it brain. And my mind or brain which is housed in my body gets as sick as my body does. I am not going to listen to anyone who tries to tell me that my body cannot possibly get sick. They may be doing so because their own sickness was “badly treated” and so now they prefer nobody to have their own free choice to be treated well.

    The suffering need a choice of treatment..Just like the religious need a choice of temple, church, mosque.

  4. I figure that those with dementia from iatrogenic brain shrinkage will likely be lambasted as being imperfect “narcissistic” parents for showing signs of growing narrow and self-absorbed and manipulative and controlling. They may then be binned in care facilities because their adult kids, glowing with new books on trauma, assume that their aging parent is the work of the devil…

    for having brain damage caused by stupid pills.

    Did I say there would be care facilities?
    Scrap those. Underfunding and burnt out staff shortages will make those redundant. So then what?
    Where do the aging former bipolar or autistic or schizophrenic people go when their cognitive decline from iatrogenic harm is so bad they can only spell the word schizophrenia, since it can be spelled better with the eyes closed.

  5. Diaphanous, so long as we have ‘care facilities’ and so long as people believe in thigs like bipolar, autism, or schizophrenia, there will be a mental health facility and more people will be getting fed into it. And most of the time it is what the parents do to the child, not the other way round.

    Joshua

    • If all parents were abusive nobody would be able to buy a bagel, or board a coach, or plane, or purchase political classics, or have street lights and pedestrian crossings and schools and colleges….

      why?

      Because all the billions of people who have parents, all those billions of people who run these things would have been turned into embittered traumatized casualties who could not make it out their front door year after year to cause the bagel, the coffee, the printing of books. If you see a bus driver, barista worker, window cleaner, department store worker, and they are not howling, or sitting in a corner rocking back and forth it is because they had “good enough” parents.

      Nobody is entirely happy. And nobody is entirely pleased with their parents. Mostly it is because nobody is entirely happy no longer being held like a newborn in complete safety by a maternal or paternal embrace. Ultimately though it is the job of parents to gently and affectionately turn kids against them enough for those kids to be independant. You see this in seagulls. If parents were ideal and gave ideal love all day, all week, all month, all year, all decade, that would be cruel to the kids need for natural emancipation. You could argue that “what” kids are emancipated “into” leaves little to recommend it. But NO one parent single handedly woke up one morning and rather than fill the kids bowl with cornflakes decided instead to deliberately create climate change or economic dearth or systems that are not fit for purpose.

      Kids want love and this is healthy. But parents are not meant to be an unhealthy life support. Life is not trying to kill anyone. Life is here to be the support.

      But we are living in a time where everyone is bickering over “word choices”, not because the words themselves are so injurious, but because bickering is a way to vent woundedness whilst purporting to be striving for justice.

  6. I am concerned that everything everyone said might only get worse. I saw on the news that Congress was discussing financial appropriations for “mental health services.” They claim that after the pandemic, it is sorely needed and people, especially young people are suffering from all kinds of “ills” like anxiety and depression due to the pandemic. I know this article discusses basically older people because it deals with dementia and psychiatric drugs, etc. But of course, these “advocates/activists” forget, young people don’t stay young forever. If all these psych drugs, therapies, etc. don’t kill them, they will eventually age and then be affected by the “iatrogenic harm” and dementia and the etc. Right now, many of us do have at least some of the etc. However, as my father would say, “Their minds are made-up, don’t confuse them with the facts.” Back in the day, my father had a sign on his desk about this. It is truer now more than ever, especially about psychiatry, etc. and its implications and ramifications. Thank you.

  7. My mother is getting worse dementia. She has begun hallucinating. She was miserable today because everyone at her apartment complex tells her it is JUST her hallucinating.

    Like a migrant sinking beneath the heartless sea is JUST drowning.

    Like a hostage being kept awake for a week is JUST being driven so sleep deprived they become psychotic.

    Like a child in an orphanage run by creepy nuns is JUST being beaten.

    Ironically my schizophrenia gives me hallucinations that everyone else seems in a hurry to say are JUST hallucinations.

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