BBC health expert's warning for Sertraline, Citalopram and Fluoxetine users

Widely prescribed drugs such as Sertraline, Citalopram and Fluoxetine, taken by millions across the country, have been flagged as a concern. On BBC Morning Live, Dr Oscar Duke shared his thoughts, expressing particular worry about those taking diazepam and lorazepam.

Addressing the link between dementia and the highlighted medications last month, he said: "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."

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Dr Duke noted that people are generally living longer with dementia and, with no cure currently available, it represents a growing challenge. It is estimated that nearly 1 million (approximately 982,000) people are living with dementia in the UK as of May 2024. He outlined how the study examined medications prescribed to dementia patients to help manage their symptoms, explaining: "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."

Alongside the elevated mortality rate linked to these medications, researchers also discovered significantly higher death rates amongst patients taking diazepam and lorazepam. He added: "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."

A study by Queen's University Belfast, led by researchers from the School of Pharmacy and Centre for Public Health, has revealed, according to its lead author, that certain medications "may not always be appropriate" for those living with dementia. As dementia is closely linked to ageing and the proportion of people aged 65 and over continues to grow, the number of dementia cases is expected to rise significantly. It currently affects more than 55 million people worldwide, with an estimated 10 million new cases diagnosed every year.

Dr Catherine Sinnamon, lead author of the research and a postgraduate research student from the School of Pharmacy, stressed that dementia was one of the leading causes of death globally 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 said. Those living with dementia frequently suffer from additional medical conditions, meaning they are often prescribed multiple medications.

"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."

The researchers examined patterns in the prescribing of medications used to treat depression and anxiety in dementia patients, exploring the link between the use of these drugs and the risk of death. The team studied 28,781 people living with dementia in Northern Ireland over a nine-year follow-up period (2012-2020), half of whom passed away during this time. The research revealed that antidepressants were prescribed to 59.2% of individuals who died during the follow-up period, while anti-anxiety medications were prescribed to 44.8% of these patients. The findings showed a marginally elevated risk of death amongst dementia patients prescribed antidepressants, and a significantly higher risk in those given anti-anxiety medications.

Dr Heather Barry, the study's principal investigator, 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 study received support from staff at the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO), with funding provided by both the BSO and the Department of Health.