Commonly prescribed medicines for anxiety, depression and sleep disorders may pose a heightened risk of developing amyotrophic lateral sclerosis ( ALS), a progressive and fatal neurological disorder, according to a new study recently published in JAMA Neurology.
The study researched the use of anxiolytics (used to relieve anxiety), hypnotics and sedatives (used to aid sleep or calm the body), and antidepressants (which work by altering brain chemistry to improve mood) and found that individuals who were prescribed such medications were more likely to be diagnosed with ALS in the later stages of life.
The study further found that people who used these medication before being diagnosed with ALS had a poorer prognosis, which means that their disease progressed quickly and survival rate is minimal. However, experts caution that this finding is based on association, not causation.
"These medications are often prescribed for symptoms such as anxiety, sleep disturbances, or depression, which may appear during the early (prodromal) phase of ALS - well before a formal diagnosis," explained Dr M S Panduranga, senior consultant (neurology), Dharamshila Narayana Super-specialty Hospital.
"So, the link may reflect early, subtle neurological changes rather than the harmful effect of the drugs themselves," the doctor added.
The study, which was conducted in Sweden, analysed nationwide data from over 1,000 ALS patients and more than 5,000 healthy individuals using the Swedish Motor Neuron Disease Quality Registry. The average age of participants was 67.5 years, and just over half (53.1%) were male.
Dr Manjari Tripathi, professor and head of neurology at AIIMS, told TOI that such neuropsychiatric medications act on the brain's inhibitory pathways, which could interfere with motor neuron activity.
"There could also be a toxic effect, especially with long-term, consistent use - not just occasional doses," she said.
"Motor neuron disease leads to slow but steady progression of muscle weakness. Patients begin to struggle with everyday tasks - buttoning a shirt, combing their hair, walking. Eventually, they become wheelchair bound. Swallowing and speech become difficult, and muscles visibly shrink," she said, adding that one type of ALS was the same condition renowned physicist Stephen Hawking lived with for decades.
However, the exact timeline between the medication and the onset of ALS remains unfound. Dr Madhukar Bhardwaj, director and head of neurology, Aakash Healthcare, said that a longer history of psychiatric symptoms and prolonged medication use appears to be associated with increased ALS risk.
"In some observational studies, individuals using anxiety or depression medications for more than 10 years showed a stronger link with ALS, especially in younger patients. It's not yet certain whether this reflects a true biological risk or simply earlier diagnosis due to more medical attention," he said.
"While there's no definitive proof that these medications cause ALS, we need to be cautious, especially when prescribing them to individuals with signs of neurological disease," Dr Anshu Rohatgi, vice-chairperson (neurology), Sir Ganga Ram Hospital told TOI.
Meanwhile, doctors say patients must not stop medications on their own and should speak with their healthcare providers if they have concerns.
(With TOI inputs)
The study researched the use of anxiolytics (used to relieve anxiety), hypnotics and sedatives (used to aid sleep or calm the body), and antidepressants (which work by altering brain chemistry to improve mood) and found that individuals who were prescribed such medications were more likely to be diagnosed with ALS in the later stages of life.
The study further found that people who used these medication before being diagnosed with ALS had a poorer prognosis, which means that their disease progressed quickly and survival rate is minimal. However, experts caution that this finding is based on association, not causation.
"These medications are often prescribed for symptoms such as anxiety, sleep disturbances, or depression, which may appear during the early (prodromal) phase of ALS - well before a formal diagnosis," explained Dr M S Panduranga, senior consultant (neurology), Dharamshila Narayana Super-specialty Hospital.
"So, the link may reflect early, subtle neurological changes rather than the harmful effect of the drugs themselves," the doctor added.
The study, which was conducted in Sweden, analysed nationwide data from over 1,000 ALS patients and more than 5,000 healthy individuals using the Swedish Motor Neuron Disease Quality Registry. The average age of participants was 67.5 years, and just over half (53.1%) were male.
Dr Manjari Tripathi, professor and head of neurology at AIIMS, told TOI that such neuropsychiatric medications act on the brain's inhibitory pathways, which could interfere with motor neuron activity.
"There could also be a toxic effect, especially with long-term, consistent use - not just occasional doses," she said.
"Motor neuron disease leads to slow but steady progression of muscle weakness. Patients begin to struggle with everyday tasks - buttoning a shirt, combing their hair, walking. Eventually, they become wheelchair bound. Swallowing and speech become difficult, and muscles visibly shrink," she said, adding that one type of ALS was the same condition renowned physicist Stephen Hawking lived with for decades.
However, the exact timeline between the medication and the onset of ALS remains unfound. Dr Madhukar Bhardwaj, director and head of neurology, Aakash Healthcare, said that a longer history of psychiatric symptoms and prolonged medication use appears to be associated with increased ALS risk.
"In some observational studies, individuals using anxiety or depression medications for more than 10 years showed a stronger link with ALS, especially in younger patients. It's not yet certain whether this reflects a true biological risk or simply earlier diagnosis due to more medical attention," he said.
"While there's no definitive proof that these medications cause ALS, we need to be cautious, especially when prescribing them to individuals with signs of neurological disease," Dr Anshu Rohatgi, vice-chairperson (neurology), Sir Ganga Ram Hospital told TOI.
Meanwhile, doctors say patients must not stop medications on their own and should speak with their healthcare providers if they have concerns.
(With TOI inputs)
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