Association Found Between Psychiatric Medication Use and Risk of ALS
A case-control study has identified a potential link between use of certain psychiatric medications and the risk and progression of amyotrophic lateral sclerosis (ALS). Findings were published in JAMA Network Open.
Authors noted that the association could also be between the psychiatric disorder being treated by the medications, rather than the medications themselves.
“These findings suggest a potential link between psychiatric medications, or their indications (ie, psychiatric disorders), and the risk and progression of ALS,” wrote Charilaos Chourpiliadis, MD, and co-authors.
Authors sought to examine whether there was an association between common psychiatric medications (anxiolytics, hypnotics and sedatives, and antidepressants) with risk and disease progression of ALS. They used the Swedish Motor Neuron Disease Quality Registry to recruit patients diagnosed with ALS between January 1, 2015, to July 1, 2023. Patients were age- and sex-matched with individuals with no ALS as well as their full siblings and spouses. Patients with ALS were followed for a median of 1.33 years after diagnosis.
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Conditional logistic regression models were used to calculate risk of ALS diagnosis associated with prediagnostic use of common psychiatric medications and compared patients with ALS with control participants. Patients with ALS were followed up from diagnosis to evaluate association of use of psychiatric medications. Mortality association (or use of invasive ventilation) with the use of common psychiatric medications was estimated using a joint longitudinal-survival model.
Overall, in the population comparison, use of common psychiatric medications as prescribed before ALS diagnosis was associated with a higher risk of ALS (among individuals prescribed hypnotics and sedatives 0-1 year before diagnosis: odds ratio [OR], 6.10; 95% CI, 3.77-9.88; prescribed anxiolytics 1-5 years before diagnosis: OR, 1.60; 95% CI, 1.15-2.23; prescribed antidepressants >5 years before diagnosis: OR, 1.21; 95% CI, 1.02-1.44). When excluding the year before diagnosis from analysis, prescribed use of anxiolytics (OR, 1.34; 95% CI, 1.12-1.60), hypnotics and sedatives (OR, 1.21; 95% CI, 1.02-1.43), or antidepressants (OR, 1.26; 95% CI, 1.06-1.49) were associated with an increased risk of ALS. There was also shorter survival exhibited among patients with ALS who had prediagnostic use of anxiolytics (hazard ratio [HR], 1.52; 95% CI, 1.12-2.05) or antidepressants (HR, 1.72; 95% CI, 1.30-2.29), including when compared to patients with ALS who did not use those medications.
“In this nationwide case-control study, we found that use of anxiolytics, hypnotics and sedatives, or antidepressants was associated with a higher future risk of ALS diagnosis,” study authors concluded. “Prediagnostic use of some of these medications was also associated with shorter survival and faster functional decline among patients with ALS.”
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