In a large UK population-based study, Ian Wong and colleagues at the University of Hong Kong and University College London, UK, found no statistically significant association between the antidepressant trazodone and a reduced risk of dementia when compared to other antidepressants. Their findings were published this week in PLOS Medicine.
In vitro and animal studies have previously suggested that trazodone may protect against dementia. In the new study, researchers analyzed data from the Health Improvement Network (THIN), which includes medical records of over 15 million primary care patients in the UK. They identified 4,716 people over the age of 50 years who received at least two consecutive trazodone prescriptions between 2000 and 2017, and compared them with 420,280 users of other antidepressants with similar baseline characteristics.
The median time to dementia diagnosis for trazodone users was 1.8 years. The incidence of dementia among trazodone users was higher than in matched antidepressant users (1.8 vs 1.1 dementia cases per 100 person-years) with a hazard ratio of 1.80 (95% confidence interval 1.56-2.09, P < 0.001). However, the results do not point toward a causal association; the study is limited by the fact that people in the prodromal stage of dementia might be preferentially prescribed trazodone.
"These results refute the suggestions from animal studies that trazodone might stop or delay the onset of dementia in patients at the prodromal stage of dementia," the authors say.
RB is funded by a UCL Maplethorpe Fellowship and the collaboration between the Department of Pharmacology and Pharmacy of the University of Hong Kong, and the UCL School of Pharmacy is funded by The University of Hong Kong-University College London (HKU-UCL) Strategic Partnership Fund. JFH is funded by a Wellcome Trust Clinical Research Career Development Fellowship. JFH, DPJO, and RH are supported by the UCLH NIHR Biomedical Research Center.
I have read the journal's policy and the authors of this manuscript have the following competing interests: ICKW has received research funding from Bristol-Myers Squibb, Pfizer, Janssen, the Hong Kong Research Grants Council, and the Hong Kong Health and Medical Research Fund unrelated to the submitted work. JK is an employee of IQVIA. There are no other relationships or activities that could appear to have influenced the submitted work.
Brauer R, Lau WCY, Hayes JF, Man KKC, Osborn DPJ, Howard R, et al. (2019) Trazodone use and risk of dementia: A population-based cohort study. PLoS Med 16(2): e1002728. https:/
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Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy,
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Division of Psychiatry, University College London, London, United Kingdom
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong
Centre of Excellence for Retrospective Studies, Real World Insights, IQVIA, London, United Kingdom
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
The University of Hong Kong, Shenzhen Hospital, Shenzhen, Guangdong, China
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