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Background <p>Selective serotonin reuptake inhibitors (SSRIs), one of the most commonly prescribed medications for the treatment of depression, have significant effects on cognitive functions, especially in patients with Alzheimer’s disease (AD). Since AD, as a progressive neurodegenerative disorder, affects millions of people worldwide and leads to cognitive decline and behavioral dysfunction, its investigation has been the focus of many studies.</p> Objective <p>This systematic review aims to explore the effects of SSRIs on cognitive functions in AD patients, assessing their efficacy across various cognitive domains while considering potential gender differences in treatment outcomes.</p> Methods <p>A thorough literature search was carried out using PubMed, Scopus, and Web of Science in accordance with PRISMA criteria. SSRI effects on cognitive areas in 1100 AD patients (about 58.0% female) aged 69–79 years were examined in observational studies and randomized controlled trials (RCTs). Using the JBI critical evaluation tool, many reviewers independently carried out the data extraction and quality assessment.</p> Results <p>Of the initial 1282 studies, 10 met the inclusion criteria for this systematic review. The main finding from this study is that although some studies have shown improvements in executive function, memory, and language fluency, others report no clear cognitive benefits and even possible harms such as increased risk of dementia. Other evidence also suggests that escitalopram, citalopram, sertraline, and fluoxetine were the most commonly used SSRIs. Also, of the commonly used cognitive assessment tools, the Mini-Mental State Examination (MMSE), Wechsler Memory Scale III (WMS-III), and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) were the most commonly used.</p> Conclusion <p>The research currently available regarding SSRIs and cognitive function in AD is still equivocal. The need for more extensive, carefully monitored clinical trials is highlighted by the heterogeneity in study results, even if some SSRIs show promise in maintaining cognitive function. Large-scale, carefully monitored research is required to elucidate the function of SSRIs in cognitive regulation and to improve treatment strategies for AD patients.</p>

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SSRIs and Alzheimer’s Disease: A Complex Relationship

  • 期刊论文

  • 发表日期：

    2025年6月10日

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  • Parisa Enayat,
  • Farnaz Norouzizadeh,
  • Mahsa Bahrami,
  • Samin Saberi,
  • Moslem Solhirad,
  • Leila Karimi-Zandi

摘要

Background

Selective serotonin reuptake inhibitors (SSRIs), one of the most commonly prescribed medications for the treatment of depression, have significant effects on cognitive functions, especially in patients with Alzheimer’s disease (AD). Since AD, as a progressive neurodegenerative disorder, affects millions of people worldwide and leads to cognitive decline and behavioral dysfunction, its investigation has been the focus of many studies.

Objective

This systematic review aims to explore the effects of SSRIs on cognitive functions in AD patients, assessing their efficacy across various cognitive domains while considering potential gender differences in treatment outcomes.

Methods

A thorough literature search was carried out using PubMed, Scopus, and Web of Science in accordance with PRISMA criteria. SSRI effects on cognitive areas in 1100 AD patients (about 58.0% female) aged 69–79 years were examined in observational studies and randomized controlled trials (RCTs). Using the JBI critical evaluation tool, many reviewers independently carried out the data extraction and quality assessment.

Results

Of the initial 1282 studies, 10 met the inclusion criteria for this systematic review. The main finding from this study is that although some studies have shown improvements in executive function, memory, and language fluency, others report no clear cognitive benefits and even possible harms such as increased risk of dementia. Other evidence also suggests that escitalopram, citalopram, sertraline, and fluoxetine were the most commonly used SSRIs. Also, of the commonly used cognitive assessment tools, the Mini-Mental State Examination (MMSE), Wechsler Memory Scale III (WMS-III), and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) were the most commonly used.

Conclusion

The research currently available regarding SSRIs and cognitive function in AD is still equivocal. The need for more extensive, carefully monitored clinical trials is highlighted by the heterogeneity in study results, even if some SSRIs show promise in maintaining cognitive function. Large-scale, carefully monitored research is required to elucidate the function of SSRIs in cognitive regulation and to improve treatment strategies for AD patients.