Use of psychiatric medications may be associated with a higher risk of amyotrophic lateral sclerosis

1. Prediagnostic use of anxiolytics, hypnotics, sedatives and antidepressants were associated with a higher risk of amyotrophic lateral sclerosis (ALS). 

Evidence Rating Level: 2 (Good)

While ALS has been historically recognized as a disease affecting the motor neurons, psychiatric symptoms have also been shown to be a manifestation of ALS. Studies investigating the relationship between psychiatric medication use and the risk of developing ALS are limited. This case-control study therefore sought to investigate the association between the use of anxiolytics, hypnotics, sedatives and antidepressants and the risk of developing ALS as well as the progression of ALS. 1057 case participants and 5281 controls (mean[SD] age, 67.5[11.5] years; 53.% male) were included from the Swedish MND Quality Registry between January 2015 and July 2023. Following multivariable adjustment, having at least 2 prescriptions of psychiatric medications was associated with an increased risk of developing ALS when the medications were prescribed 0-1, 1-5 and greater than 5 years before development of ALS (prescribed hypnotics and sedatives 0-1 years befor index date: odds ratio [OR], 6.10; 95% CI, 3.77-9.88; prescribed anxiolytics 1-5 years before index date: OR, 1.60; 95% CI, 1.15-2.23; prescribed antidepressants >5 years before index date: OR, 1.21; 95% CI, 1.02-1.44). Following multivariable adjustment, prescribed use of anxiolytics and antidepressants were associated with an increased risk of mortality (hazard ratio [HR], 1.52; 95% CI, 1.12-2.05 and HR, 1.72; 95% CI, 1.30-2.29, respectively). Overall, this study found that prediagnostic prescribed use of anxiolytics, hypnotics, sedatives and antidepressants were associated with higher risk of developing ALS. 

Click to read the study in JAMA Network Open

Image: PD

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